Severity of Dysphagia after Anterior Cervical Surgery

Abstract

Introduction Several studies show a relatively high incidence of dysphagia following anterior cervical decompression and fusion (ACDF). Most of these studies are retrospective and lack a control group. This is a prospective study to show the incidence and severity of dysphagia after ACDF using lumbar decompression patients as a control group, and to show factors associated with increased postoperative dysphagia. Materials and Methods We prospectively followed patients undergoing ACDF single or double level ( n = 43) and posterior lumbar decompression ( n = 58) (control group). Patient data were recorded. We assess dysphagia using special questionnaire preoperatively and during the 2-week, 6-week, and 12-week postoperative visits. We found no significant differences between the patients who had cervical and lumbar surgery with regard to patient age, body mass index, or the preoperative incidence and severity of dysphagia. Results Postoperative dysphagia was reported in 75% of the patients having cervical spine surgery at 2-week follow-up. This incidence decreased to 10% at 12-week follow-up. The cervical group has higher incidence and severity of dysphagia at 2- and 6-week follow-up with a trend toward greater dysphagia at 12-week follow-up. The risk of developing dysphagia was not related to the body mass index, sex, location of surgery, or the number of surgical levels. We observed that operative time was correlated with the severity of postoperative dysphagia. Conclusion Dysphagia after anterior cervical spine surgery is a common early finding. However, dysphagia decreases over time, it decreases significantly by 12 weeks.