The effect of local steroid injection on prevertebral soft tissue swelling after anterior cervical discectomy and fusion

BACKGROUND AND OBJECTIVE: Airway obstruction is a lethal complication of anterior cervical discectomy and prevertebral soft tissue swelling after surgery is one the important causes of this complication. The aim of this study is to investigate the effect of local steroid injection on prevertebral soft tissue swelling after anterior cervical discectomy and fusion (ACDF). METHODS: This randomized clinical trial was conducted on 40 patients hospitalized in Qazvin educational & clinical Rajaee hospital who were candidates for ACDF in one to three segments because of myelopathy or radiculopathy. Patients were randomly divided into case and control groups. In case group (20 patients), 80 mg methylprednisolone was injected locally on the site of the operation. No injection was performed in control group (20 patients). Lateral neck radiography was performed one day before surgery and on the second and tenth day after surgery. The ratio of prevertebral soft tissue thickness to mid anteroposterior vertebral body (S/V) was calculated for C3-C7. In addition, pain and dysphagia after surgery were recorded on the second and tenth day after surgery (IRCT:201507212327N1). FINDINGS: S/V ratio in C3-C7 revealed no significant difference in both groups. On the second day after surgery, increase in S/V ratio in all cervical vertebrae revealed a significant difference between the two groups compared with the day before surgery (p<0.001). However, this level of increase on the tenth day was only significant in C5 (control group=0.10±0.07, case group=0.02±0.08) and C7 (control group=0.11±0.05, case group=0.02±0.1) (p=0.004 and p=0.002, respectively). There was also a significant difference between the two groups on the second and tenth day regarding intensity of pain and dysphagia after surgery (p=0.001). CONCLUSION: Based on the results of this study, local methylprednisolone injection reduces prevertebral soft tissue swelling, pain and dysphagia after surgery. © 2016, Babol University of Medical Sciences. All rights reserved