1087 Large Incidence and Risk Factors Meta-analysis of Dysphagia in Over 132,000 Anterior, Posterior, and Hybrid Surgeries for Cervical Spondylosis Myelopathy

Abstract

INTRODUCTION: Surgical management of Cervical Spondylotic Myelopathy (CSM) is associated with complications with devastating impacts. Dysphagia is one of these major complications with the incidence rate being not completely known in different surgical approaches. METHODS: PubMed/MEDLINE, SCOPUS, and Cochrane were systematically searched until January 2023. Rates and risk of complications were assessed. Meta-analysis of rates and risks was performed with generalized linear mixed model (GLMM) and inverse variance method, respectively, and compared between techniques. RESULTS: 1196 citations were screened and 39 studies with 60 instances of dysphagia incidence/risk factors reports from over 132,442 patients were identified. Dysphagia’s overall incidence rate was 4.98%[95% confidence interval 3.23-7.61] and was significantly different between surgery groups (Chi2 p < 0.01). It was found in 7.97% [4.95–12.57] of anterior surgeries, 1.52% [0.94–2.45] of posterior ones, and 11.25% [3.38–31.44] of hybrid techniques (statistical comparison: P < A < H). Advanced age (>65) risked dysphagia significantly (OR 1.38 [95%CI 1.11-1.71]). CONCLUSIONS: Chances of posterior surgery being complicated with dysphagia is not negligible and should be discussed with patient before surgery, especially with older adults.