Abstract
Background Our objective was to investigate the effect of intraoperative dexamethasone administration
on wound healing, complications, and clinical outcome in patients with posterior surgery
for cervical spondylotic myelopathy (CSM).
Methods We conducted a retrospective study of patients with CSM undergoing dorsal instrumentation
and decompression of the cervical spine. The senior surgeon decided if administration
of dexamethasone (40 mg intravenously) was indicated. Patients were divided into two
groups: dexamethasone group (DG) and non-dexamethasone group (nDG). All patients were
monitored for pre- and postoperative neurologic symptoms and complications. Clinical
follow-up was evaluated with the Neck Disability Index (NDI) and the modified Japanese
Orthopaedic Association (mJOA) score.
Results A total of 49 patients were included (DG, 25; nDG, 24). DG and nDG patients showed
no significant differences in pre- and postoperative findings. Five patients in the
DG had wound healing complications compared with patients in the nDG (p = 0.021), and one died due to infection. Apart from that, we did not observe any
significant differences between the two groups regarding complications, neurologic
symptoms, and follow-up (NDI and mJOA).
Conclusion Intraoperative dexamethasone administration had no influence on the postoperative
outcome and follow-up. A significantly higher rate of wound infections was detected
in the DG. These data support the hypothesis that intraoperative dexamethasone bolus
application in CSM lacks benefit.
Keywords
cervical spondylotic myelopathy - wound healing - dorsal cervical fusion - high-dose
dexamethasone
