Dysphagia following combined anterior-posterior cervical spine surgeries.

Chen, Ching-Jen; Saulle, Dwight; Fu, Kai-Ming; Smith, Justin S; Shaffrey, Christopher I

Dysphagia following combined anterior-posterior cervical spine surgeries.

dc.contributor.author	Chen, Ching-Jen
dc.contributor.author	Saulle, Dwight
dc.contributor.author	Fu, Kai-Ming
dc.contributor.author	Smith, Justin S
dc.contributor.author	Shaffrey, Christopher I
dc.date.accessioned	2023-08-29T23:38:09Z
dc.date.available	2023-08-29T23:38:09Z
dc.date.issued	2013-09
dc.date.updated	2023-08-29T23:38:08Z
dc.description.abstract	Object This study was undertaken to evaluate the incidence of and risk factors associated with the development of dysphagia following same-day combined anterior-posterior cervical spine surgeries. Methods The records of 30 consecutive patients who underwent same-day combined anterior-posterior cervical spine surgery were reviewed. The presence of dysphagia was assessed by a formalized screening protocol using history/clinical presentation and a bedside swallowing test, followed by formal evaluation by speech and language pathologists and/or fiberoptic endoscopic evaluation of swallowing/modified barium swallow when necessary. Age, sex, previous cervical surgeries, diagnoses, duration of procedure, specific vertebral levels and number of levels operated on, degree of sagittal curve correction, use of anterior plate, estimated blood loss, use of recombinant human bone morphogenetic protein-2 (rhBMP-2), and length of hospital stay following procedures were analyzed. Results In the immediate postoperative period, 13 patients (43.3%) developed dysphagia. Outpatient follow-up data were available for 11 patients with dysphagia, and within this subset, all cases of dysphagia resolved subjectively within 12 months following surgery. The mean numbers of anterior levels surgically treated in patients with and without dysphagia were 5.1 and 4.0, respectively (p = 0.004). All patients (100%) with dysphagia had an anterior procedure that extended above C-4, compared with 58.8% of patients without dysphagia (p = 0.010). Patients with dysphagia had significantly greater mean correction of C2-7 lordosis than patients without dysphagia (p = 0.020). The postoperative sagittal occiput-C2 angle and the change in this angle were not significantly associated with the occurrence of dysphagia (p = 0.530 and p = 0.711, respectively). Patients with postoperative dysphagia had significantly longer hospital stays than those who did not develop dysphagia (p = 0.004). No other significant difference between the dysphagia and no-dysphagia groups was identified; differences with respect to history of previous anterior cervical surgery (p = 0.141), use of an anterior plate (p = 0.613), and mean length of anterior cervical operative time (p = 0.541) were not significant. Conclusions The incidence of dysphagia following combined anterior-posterior cervical surgery in this study was comparable to that of previous reports. The risk factors for dysphagia that were identified in this study were increased number of anterior levels exposed, anterior surgery that extended above C-4, and increased surgical correction of C2-7 lordosis.
dc.identifier.issn	1547-5654
dc.identifier.issn	1547-5646
dc.identifier.uri	https://hdl.handle.net/10161/28824
dc.language	eng
dc.publisher	Journal of Neurosurgery Publishing Group (JNSPG)
dc.relation.ispartof	Journal of neurosurgery. Spine
dc.relation.isversionof	10.3171/2013.6.spine121134
dc.subject	Cervical Vertebrae
dc.subject	Humans
dc.subject	Deglutition Disorders
dc.subject	Postoperative Complications
dc.subject	Radiography
dc.subject	Treatment Outcome
dc.subject	Orthopedic Procedures
dc.subject	Length of Stay
dc.subject	Postoperative Period
dc.subject	Incidence
dc.subject	Risk Factors
dc.subject	Retrospective Studies
dc.subject	Follow-Up Studies
dc.subject	Time Factors
dc.subject	Adult
dc.subject	Aged
dc.subject	Middle Aged
dc.subject	Female
dc.subject	Male
dc.title	Dysphagia following combined anterior-posterior cervical spine surgeries.
dc.type	Journal article
duke.contributor.orcid	Shaffrey, Christopher I\|0000-0001-9760-8386
pubs.begin-page	279
pubs.end-page	287
pubs.issue	3
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Orthopaedic Surgery
pubs.organisational-group	Neurosurgery
pubs.publication-status	Published
pubs.volume	19