158 Dexamethasone's Effect in Multiple-Level Anterior Cervical Discectomy and Fusion

Jeyamohan, Shiveindra; Kenning, Tyler J.; Feustel, Paul; Petronis, Karen; DiRisio, Darryl J.

doi:10.1227/01.neu.0000432749.40441.c8

Cited by 2 publications

(1 citation statement)

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“…Of the 31 full-text articles included in the primary screening stage, 9 studies (total population: 246 414) were eligible for further consideration: 7 RCTs 16 , 27 – 32 and 2 nonrandomized studies (one cohort 33 and one case-control study 34 ). The other 22 articles were excluded because they were case reports, 13 , 35 – 39 studies without a control group for steroid, 40 – 45 seminar abstracts, 46 – 48 reviews, 49 , 50 commentaries, 51 , 52 or studies without sufficient data on steroid use. 53 – 55 Table 1 shows characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

Corticosteroid Administration to Prevent Complications of Anterior Cervical Spine Fusion: A Systematic Review

Zadegan

Jazayeri

Abedi

et al. 2017

Global Spine Journal

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Study Design:Systematic review.Objectives:Anterior cervical approach is associated with complications such as dysphagia and airway compromise. In this study, we aimed to systematically review the literature on the efficacy and safety of corticosteroid administration as a preventive measure of such complications in anterior cervical spine surgery with fusion.Methods:Following a systematic literature search of MEDLINE, Embase, and Cochrane databases in July 2016, all comparative human studies that evaluated the effect of steroids for prevention of complications in anterior cervical spine surgery with fusion were included, irrespective of number of levels and language. Risk of bias was assessed using MINORS (Methodological Index for Non-Randomized Studies) checklist and Cochrane Back and Neck group recommendations, for nonrandomized and randomized studies, respectively.Results:Our search yielded 556 articles, of which 9 studies (7 randomized controlled trials and 2 non–randomized controlled trials) were included in the final review. Dysphagia was the most commonly evaluated complication, and in most studies, its severity or incidence was significantly lower in the steroid group. Although prevertebral soft tissue swelling was less commonly assessed, the results were generally in favor of steroid use. The evidence for airway compromise and length of hospitalization was inconclusive. Steroid-related complications were rare, and in both studies that evaluated the fusion rate, it was comparable between steroid and control groups in long-term follow-up.Conclusions:Current literature supports the use of steroids for prevention of complications in anterior cervical spine surgery with fusion. However, evidence is limited by substantial risk of bias and small number of studies reporting key outcomes.

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Section: Resultsmentioning

confidence: 99%

Corticosteroid Administration to Prevent Complications of Anterior Cervical Spine Fusion: A Systematic Review

Zadegan

Jazayeri

Abedi

et al. 2017

Global Spine Journal

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Dexamethasone altered steroidogenesis and changed redox status of granulosa cells

Yuan

Yang²,

et al. 2014

Endocrine

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Glucocorticoids have been widely used in clinical application for anti-inflammatory and immunosuppressive function. Previous study reported that glucocorticoids adversely affect the reproductive system and can directly act on ovary. Here, we found that progesterone production induced by dexamethasone requiring activation of caspase-3 which may mediate differentiation and apoptosis of granulosa cells. Further study displayed that cellular glutathione level was increased and reactive oxygen species was decreased accompanied with unchanged mitochondrial membrane potential which may contribute to the maintenance of steroidogenesis in granulosa cells treated with dexamethasone. Dexamethasone also augmented the level of anti-Müllerian hormone secreted by preovulatory granulosa cells which indicated that dexamethasone may promote preantral follicles development.

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158 Dexamethasone's Effect in Multiple-Level Anterior Cervical Discectomy and Fusion

Cited by 2 publications

References 0 publications

Corticosteroid Administration to Prevent Complications of Anterior Cervical Spine Fusion: A Systematic Review

Corticosteroid Administration to Prevent Complications of Anterior Cervical Spine Fusion: A Systematic Review

Dexamethasone altered steroidogenesis and changed redox status of granulosa cells

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