Changes in intervertebral distraction: A possible factor for predicting dysphagia after anterior cervical spinal surgery

Abstract

ObjectiveDysphagia following anterior cervical spine surgery (ACSS) is common. This study aimed to determine if change in intervertebral distraction following ACSS is associated with early dysphagia. MethodsWe retrospectively examined patients who underwent ACSS for myelopathy and/or radiculopathy in our institution. The Bazaz score and the Chinese version of the Swallowing-Quality of Life survey were used to assess postoperative swallowing function. Change in intervertebral distraction was defined as the difference between the preoperative and postoperative mean values of the anterior and posterior intervertebral distances at the surgical site. Potential risk factors examined included age, gender, body mass index, operative time, blood loss volume, level of surgery, as well as radiographic data including Cobb angle, T1 slope, sagittal vertical axis, and intervertebral distraction. ResultsAmong the 289 patients, the incidence of dysphagia was 58.1% 1 week after ACSS. Patients who underwent surgery involving C3/4 or involving three or more levels had worse Swallowing-Quality of Life and Bazaz scores. The optimal cutoff value for change in intervertebral distraction for predicting dysphagia 1 week after surgery was 6.10 mm. Change in intervertebral distraction ≥ 6.10 mm, surgery involving C3/4, and surgery involving three or more levels were significantly and independently associated with early dysphagia. ConclusionA correlation between early dysphagia and change in intervertebral distraction ≥ 6.10 mm could be confirmed. In addition, patients undergoing ACSS involving C3-4 or multilevel surgery (≥3) must be monitored carefully postoperatively for dysfunctional swallowing.