Does plate profile affect postoperative dysphagia following anterior cervical spine surgery?

Abstract

Dysphagia following anterior cervical spine surgery is a significant problem. The risk factors for such dysphagia have not been established. We examined whether plate profile affected the incidence of dysphagia. This study enrolled 50 consecutive patients undergoing one-level corpectomy or one- or two-level discectomies with plate fixation performed by the same surgeon from 2004 to 2009. The anterior cervical plates used were either the Codman (Johnson and Johnson Professional Inc., Raynham, MA, USA; width 17.58mm, thickness 2.69mm; 27 patients) or the Zephir (Medtronic Sofamor Danek Inc., Memphis, TN, USA; width 15mm, thickness 1.6mm; 23 patients). Dysphagia was assessed via telephone interviews, and was classified as short-term (occurring within 6months postoperatively) or persistent (persisting beyond 6months postoperatively). The overall short-term and persistent dysphagia rates were 20% and 14%, respectively. The short-term and persistent dysphagia rates were 26% and 13% for the Zephir plate, and 14.8% and 14.8% for the Codman plate, and analysis showed that the rates were similar for both types of plate. Age and sex were not found to correlate with dysphagia. In patients undergoing anterior cervical spine surgery with plate fixation, we found that postoperative dysphagia did not correlate with plate profile up to a plate size of 17.58mm wide and 2.69mm thick. Dysphagia occurred at the same incidence in patients with a smaller plate that was 15mm wide and 1.6mm thick.