Summary of assessments used to measure dysphagia and highlights of individual study outcomes.
| Study, year | Dysphagia Severity Assessment | Assessment Description | Results | Conclusion |
|---|---|---|---|---|
| SYSTEMIC STEROIDS | ||||
| Pedram, 2003 | N/a | Patient subjectively described swallowing difficulty without standardized scale | Dysphagia or odynophagia reported 24-36h post-operatively in 56 (71.79%) steroid-treated patients compared to 130 (82.28%) control patients. | Perioperative systemic steroids reduce incidence of post-operative swallowing impairment in the early post-operative period. |
| Nam, 2013 | Visual analogue scale (VAS) for dysphagia | 10-point scale based on patient self-report of swallowing difficulty (0 = no difficulty swallowing, 10 = worst difficulty swallowing). | No statistically significant differences in mean VAS scores between high dose steroids, low dose steroids, and control groups noted during the first 5 post-op days. | Perioperative systemic steroids do not affect severity of post-operative swallowing impairment in the early post-operative period. |
| Song, 2014 | Bazaz Dysphagia Score | Dysphagia described as absent, mild, moderate, severe based on patient report. | Steroid group had lower Bazaz ratings compared to control group during POD 2-5 (p<0.05 each day). . | Perioperative systemic steroids improve post-operative severity in the early post-operative period. |
| Jeyamohan, 2015 | Functional Outcome Swallowing Scale (FOSS) | Score 0-5 based on patient report of swallowing function, frequency of associated symptoms, and need for non-oral feeding | Steroid group lower mean FOSS score at 1-month follow-up compared to control group (0.064 vs. 0.66, p=0.027); this difference disappeared after 1 month. | Perioperative systemic steroids improve post-operative dysphagia severity in the early post-operative period, which subsides in the long-term. |
| LOCAL STEROIDS | ||||
| Lee, 2011 | Visual analogue scale (VAS) for odynophagia | 10-point scale based on patient self-report of pain with swallowing (0 = no pain; 10 = worst pain). | Steroid group exhibited statistically significant lower mean VAS odynophagia scores immediately and at 2-weeks post-operation. | Perioperative local steroids reduce post-operative dysphagia in the early post-operative period. |
| Cancienne, 2015 | N/a | Patient subjectively described swallowing difficulty without normalized scale | 9% of steroid group vs. 14.6% of control group experienced dysphagia within 90 days of fusions with 3 or more levels (p=0.005). | Perioperative local steroids reduce incidence of post-operative dysphagia in patients undergoing anterior cervical spinal fusion of 3 or more levels. |
| Koreckij, 2016 | Bazaz Dysphagia Scale | Dysphagia described as absent, mild, moderate, severe based on patient report. | Steroid group had fewer patients with severe dysphagia at 6 weeks post-op (14.3% vs.40.9%, p=0.008.) and 3 month (0% vs. 23.9%, p=0.022) compared to controls. | Perioperative local steroids improve post-operative dysphagia severity beyond the early post-operative period. |
| EAT-10: A swallowing screening tool | 10 item questionnaire evaluating swallowing and associated psychosocial issues. Each item scored 0-4 (0=no problem, 4=severe problem). Total score ranges from 0-40. Total score of 3 or higher is abnormal (indicative of dysphagia). | Steroid group had fewer patients with abnormal EAT-10 scores at 3 months post-op in comparison to control group (18.2% vs. 57.1%; p=0.012). | Perioperative local steroids reduce incidence of dysphagia in the late post-operative period. | |
POD: post-operative day.