Local steroids and dysphagia in anterior cervical discectomy and fusion—does the employment of rhBMP-2 make their use a necessity?

Dysphagia consists one of the most disturbing post-operative symptoms, with reported incidence varying from 1% to approximately 80% of patients undergoing anterior cervical procedures (1). It is also known that despite the high reported rates of early postoperative dysphagia, it has been demonstrated that less than 15% of the patients will finally experience dysphagia one year after surgery (2). Generally, dysphagia is characterized as difficulty in the swallowing process, and it may affect the consumption of both solid food and/or liquids. Many factors have been implicated in the genesis of postoperative dysphagia, such as previous neck surgery, prolonged operative time, multi-level procedure, excessive intraoperative esophageal retraction, employment of rhBMP-2, implantation of anterior cervical plate, and postoperative development of prevertebral soft tissue edema.