TY - JOUR AU - Blume, Christian; Wiederhold, Henrich; Geiger, Matthias; Clusmann, Hans; Müller, Christian Andreas TI - Lacking Benefit of Intraoperative High-Dose Dexamethasone in Instrumented Surgery for Cervical Spondylotic Myelopathy SN - 2193-6315 SN - 2193-6323 PY - 2018 JO - J Neurol Surg A Cent Eur Neurosurg JF - Journal of Neurological Surgery Part A: Central European Neurosurgery LA - EN VL - 79 IS - 02 SP - 116 EP - 122 ET - 2017/12/14 DA - 2018/02/27 KW - cervical spondylotic myelopathy KW - wound healing KW - dorsal cervical fusion KW - high-dose dexamethasone AB - 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. PB - Georg Thieme Verlag KG DO - 10.1055/s-0037-1608824 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0037-1608824 ER -