Advances in Application of Glucocorticoids in Perioperative Degenerative Cervical Myelopathy

Degenerative cervical myelopathy is the most common cause of spinal cord dysfunction in adults. The efficacy of decompression surgery has been demonstrated in both anterior and posterior approaches. While paying attention to the curative effect of surgery, its complications are also getting more and more concern. Whether perioperative glucocorticoid use can reduce the incidence of decompression complications in degenerative cervical myelopathy has been a controversial topic. In the field of basic research, neurological decline after decompression has been confirmed to be related to ischemia-reperfusion injury and immune system activation. In addition, methylprednisolone reduces perioperative neurological complications following decompressive surgery for degenerative cervical myelopathy by protecting neurons from inflammation, without compromising the composition of circulating immune cells. However, in clinical studies, there is still a lack of high-level evidence. Experts in China jointly completed the expert consensus on perioperative application of adrenal glucocorticoids (2017 version), which provides norms and guidance for Chinese physicians in the application of perioperative glucocorticoids. However, this consensus mainly aims at general surgery, and the perioperative application of degenerative cervical myelopathy is not detailed. In this review, the author summarized the advances of glucocorticoids in dysphagia, auxiliary analgesia and C₅ nerve root palsy, in perioperative period of Degenerative cervical myelopathy, combined with relevant literature.