Incidence of dysphagia following posterior cervical spine surgery

• Published in: Journal of clinical neuroscience 2022-05, Vol.99, p.44-48
• Main Authors: Zabat, Michelle A., Mottole, Nicole A., Patel, Hershil, Norris, Zoe A., Ashayeri, Kimberly, Sissman, Ethan, Balouch, Eaman, Maglaras, Constance, Protopsaltis, Themistocles S., Buckland, Aaron J., Roberts, Timothy, Fischer, Charla R.
• Format: Article
• Language: English
• Subjects: Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Complications; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Dysphagia; Humans; Incidence; Laminectomy - methods; Laminoplasty; Laminoplasty - methods; Posterior cervical spine surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - surgery; Retrospective; Retrospective Studies; Spinal Fusion - adverse effects; Spinal Fusion - methods; Treatment Outcome
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2022.02.024

•The incidence rate of dysphagia after posterior cervical fusion with laminectomy or laminoplasty between C1-T1 was 1.5%.•There were no significant differences in sagittal alignment between those with postoperative dysphagia and those without.•There was no difference in rate of postoperative dysphagia between fusion with laminectomy and laminoplasty patients. Abundant literature exists describing the incidence of dysphagia following anterior cervical surgery; however, there is a paucity of literature detailing the incidence of dysphagia following posterior cervical procedures. Further characterization of this complication is important for guiding clinical prevention and management. Patients ≥ 18 years of age underwent posterior cervical fusion with laminectomy or laminoplasty between C1-T1. Pre- and post-operative dysphagia was assessed by a speech language pathologist. The patient cohort was categorized by approach: Laminectomy + Fusion (LF) and Laminoplasty (LP). Patients were excluded from radiographic analyses if they did not have both baseline and follow-up imaging. The study included 147 LF and 47 LP cases. There were no differences in baseline demographics. There were three patients with new-onset dysphagia in the LF group (1.5% incidence) and no new cases in the LP group (p = 1.000). LF patients had significantly higher rates of post-op complications (27.9% LF vs. 8.5% LP, p = 0.005) but not intra-op complications (6.1% LF vs. 2.1% LP, p = 0.456). Radiographic analysis of the entire cohort showed no significant changes in cervical lordosis, cSVA, or T1 slope. Both group comparisons showed no differences in incidence of dysphagia pre and post operatively. Based on this study, the likelihood of developing dysphagia after LF or LP are similarly low with a new onset dysphagia rate of 1.5%.