P116. Swallowing function following anterior cervical discectomy and fusion with and without anterior plating

Abstract

BACKGROUND CONTEXT Anterior cervical plating in anterior cervical discectomy and fusion (ACDF) procedures are associated with improved outcomes compared to stand-alone cages. However, concerns exist regarding increased rates of postoperative dysphagia following an ACDF. PURPOSE To quantify the effect of anterior plating on SWAL-QOL scores and radiographic swelling assessments following a primary, single-level ACDF. STUDY DESIGN/SETTING Retrospective cohort. PATIENT SAMPLE A total of 68 patients who underwent a primary, single-level ACDF from 2014-2017. OUTCOME MEASURES SWAL-QOL scores, radiographic swelling. METHODS Patients were retrospectively reviewed and grouped by those receiving a stand-alone cage (cage) or cage with anterior plating (plate). SWAL-QOL scores were recorded preoperatively and 6-week and 12-week postoperatively. Lateral radiographs were used to create a swelling index with a ratio of the prevertebral swelling distance to the anterior-posterior diameter of each involved vertebral body. A tracheal air index was created using the same methodology. Statistical analysis was performed using chi-square analysis and independent t-tests for categorical and continuous variables. RESULTS A total of 68 primary, single-level ACDF patients were included. Forty-one (60.3%) received a stand-alone cage and 27 (39.7%) received a cage with anterior plating. No differences in demographics, comorbidities, operative time, estimated blood loss, or length of hospital stay were identified between cage and plate cohorts. Additionally, no differences were observed in postoperative SWAL-QOL scores. Swelling index was greater for the plate cohort at 6-weeks but was similar between groups at 12-weeks. The air index was similar at all time points. CONCLUSIONS The results demonstrate that patients undergoing a primary, single-level ACDF with or without anterior plating experience similar operative times and lengths of stay. Patients that receive a cage with anterior plating did not experience significant increases in dysphagia as measured by the SWAL-QOL questionnaire compared to patients that received a stand-alone cage. Furthermore, radiographic assessments of swelling are comparable between cohorts. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.