A scoping review of the methods used to capture dysphagia after anterior cervical discectomy and fusion: the need for a paradigm shift

Abstract

Objective Dysphagia is the most commonly reported complication of annterior cervical discectomy and fusion (ACDF) surgery. However, the incidence of dysphagia post-ACDF varies widely–partly attributable to differing outcome measures used to capture dysphagia. Our objective was to conduct a scoping review of the literature to quantify which dysphagia outcome measures have been employed post-ACDF and examine trends by study design, year, and location. Methods After removing duplicates, 2396 abstracts were screened for inclusion. A total of 480 studies were eligible for full-text review. After applying exclusion criteria, data was extracted from 280 studies. We extracted the dysphagia outcome measure(s), study design (prospective vs retrospective), year, and location (country). Approximately 10% of studies were repeated for intra-rater agreement. Results In total, 317 dysphagia outcome measures were reported in 280 studies (primarily retrospective—63%). The largest proportion of outcome measures were categorized as “unvalidated patient-reported outcome measures” (46%), largely driven by use of the popular Bazaz scale. The next most common categories were “insufficient detail” and “validated patient-reported outcome measures” (both 16%) followed by “chart review/database” (13%) and instrumental assessment (7%). Studies examining dysphagia post-ACDF steadily increased over the years and the use of validated measures increased in the past 10 years. Conclusions This scoping review of the literature highlights that nearly half of the ACDF dysphagia literature relies on unvalidated patient-reported outcome measures. The current understanding of the mechanism, timeline, and presentation of dysphagia post-ACDF are likely limited due to the metrics that are most commonly reported in the literature.

Comparison of the long-term efficacy of ROI-C and conventional cage-plate in treatment of spinal cord injury without fracture or dislocation: a retrospective study

“…Postoperative soft tissue swelling, intra-incision hematoma, esophageal injury and scar tissue are all possible causes of dysphagia. A report demonstrates that dysphagia (> 3 months) rates following ACDF with anterior plating have been estimated range between 12.5 and 35.1% [18,19,20] . In the current study we demonstrate that ROI-C device allows for similar clinical and radiographic outcomes compared to ACDF with anterior plating.…”