Pharyngolaryngeal lesions in patients undergoing cervical spine surgery through the anterior approach: contribution of methylprednisolone

Cervical spinal surgery through anterior approaches can lead to ear, nose and throat (ENT) complications, some of which, such as obstruction of upper airways by edema, are potentially life threatening. The purpose of this study was to evaluate the incidence of various categories of ENT lesions and t...

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Bibliographic Details
Published in:European spine journal 2003-02, Vol.12 (1), p.84-90
Main Authors: Pedram, M, Castagnera, L, Carat, X, Macouillard, G, Vital, J-M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Cervical Vertebrae - surgery
Deglutition Disorders - etiology
Deglutition Disorders - prevention & control
Female
Humans
Internal Fixators - adverse effects
Intubation, Intratracheal - adverse effects
Laryngeal Edema - etiology
Laryngeal Edema - prevention & control
Larynx - drug effects
Larynx - injuries
Larynx - physiopathology
Male
Methylprednisolone - therapeutic use
Middle Aged
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - methods
Pharyngeal Diseases - etiology
Pharyngeal Diseases - prevention & control
Pharynx - drug effects
Pharynx - injuries
Pharynx - physiopathology
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Prospective Studies
Treatment Outcome
Vocal Cord Paralysis - etiology
Vocal Cord Paralysis - prevention & control
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Summary:Cervical spinal surgery through anterior approaches can lead to ear, nose and throat (ENT) complications, some of which, such as obstruction of upper airways by edema, are potentially life threatening. The purpose of this study was to evaluate the incidence of various categories of ENT lesions and to determine whether preventive treatment with methylprednisolone (Mp) is useful in this indication. In a prospective trial, 236 patients who were undergoing anterior cervical spine surgery were separated into two groups, a control group (group I: 158 patients) and a group receiving 1 mg/kg of Mp intravenously at the end of the operation and 12 and 24 h later (group II: 78 patients). All 236 patients underwent nasofibroscopic examination by an ENT specialist the day before the operation and 24 and 36 h after the operation. The lesions observed during these examinations and reported symptoms such as uncomfortable sensation, odynophagia, or dysphagia were compared between the two groups (chi(2) or Mann-Whitney test) in terms of relative risk, with a confidence interval of 95%. Quantitative findings were compared using Student's t-test ( P
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-002-0495-6