Dysphagia After Anterior Cervical Spine Surgery: Incidence and Risk Factors

• Published in: World neurosurgery 2012, Vol.77 (1), p.183-187
• Main Authors: Kalb, Samuel, Reis, Marco T, Cowperthwaite, Matthew C, Fox, Douglas J, Lefevre, Richard, Theodore, Nicholas, Papadopoulos, Stephen M, Sonntag, Volker K.H
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Anterior cervical diskectomy; Bone Plates; Braces; Cervical Vertebrae - surgery; Complications; Decompression, Surgical - adverse effects; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Disability Evaluation; Dysphagia; Ethnic Groups; Female; Fusion; Humans; Male; Middle Aged; Neurosurgery; Neurosurgical Procedures - adverse effects; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Reoperation; Risk Factors; Sex Factors; Smoking - adverse effects; Spine - surgery; Surveys and Questionnaires
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2011.07.004

Objective To evaluate risk factors for the development of dysphagia after anterior cervical surgery. Methods The records of 249 patients who underwent anterior cervical surgery were reviewed. The presence and severity of dysphagia were assessed with the Dysphagia Disability Index 6 weeks and 3, 6, and 12 months after surgery. Age; sex; ethnicity; cigarette smoking; previous cervical surgeries; reoperation for same pathology; type of procedure, incision, and instrumentation; number and levels involved; side of procedure, length of surgery; and use of postoperative bracing were analyzed. Results During the first 6 months after surgery, 27 (10.8%) patients developed dysphagia. From these patients the presence of dysphagia at 6 weeks and at 3 and 6 months was 88.8%, 29.6%, and 7.4%, respectively. By 12 months, dysphagia had resolved in all cases. The mean age of patients with dysphagia was 55 years (SD 12.98) and 50 years (SD 12.07) in patients without dysphagia ( P = 0.05). Dysphagic patients had an average of 2.2 (SD 1.15) levels operated compared with 1.84 (SD 0.950) in nondysphagic patients ( P = 0.05). Patients who developed dysphagia were most often treated at C4-5 (67%) and C5-6 (81%: P < 0.001). Although mean operative time was slightly longer in patients with dysphagia (186 minutes) compared with those without (169 minutes), the difference was not significant. Conclusions In our patients, the incidence of dysphagia was low, and it had completely resolved at 12 months in all cases. Risk factors for dysphagia were multilevel procedures, involvement of C4-5 and C5-6, and age.