From the Research
Steroids are recommended for managing dysphagia following anterior cervical discectomy, with a typical regimen including local steroid administration, such as 40 mg of local triamcinolone, which has been shown to decrease the prevalence of severe dysphagia and improve patient-reported outcome measures compared to intravenous steroid administration or no steroid use 1.
Key Points
- The use of steroids in anterior cervical discectomy and fusion (ACDF) has been shown to reduce the incidence of dysphagia and improve patient outcomes 1, 2.
- Local steroid administration, such as 40 mg of local triamcinolone, has been found to be more effective than intravenous steroid administration in reducing the prevalence of severe dysphagia and improving patient-reported outcome measures 1.
- The anti-inflammatory effects of steroids decrease edema in the pharyngeal and esophageal tissues that become irritated during surgical retraction, leading to improved swallowing function 3, 4.
- While steroids are effective, they should be used cautiously in patients with diabetes, as they can cause blood glucose elevation, and in those with a history of gastrointestinal ulcers, as steroids may exacerbate this condition.
Recommendations
- Administer 40 mg of local triamcinolone during ACDF to reduce the incidence of dysphagia and improve patient outcomes 1.
- Consider using intravenous steroid administration, such as dexamethasone, as an alternative to local steroid administration, although it may be less effective 2.
- Monitor patients for potential complications, such as blood glucose elevation and gastrointestinal ulcers, and adjust the steroid regimen accordingly.
- Provide patients with guidance on swallowing techniques, such as eating slowly and taking small bites, and recommend a soft diet to facilitate swallowing.