Incidence and Risk Factors of postoperative Dysphagia following Cervical Spine Surgery

Abstract

Background. Dysphagia is a known complication of anterior cervical spine surgery and may be prolonged or occasionally serious. However, the association between posterior cervical spine surgery and the development of dysphagia is rare discussed. Furthermore, the risk factors of postoperative dysphagia are not well understood.Methods. Three hundred and fifty four patients were reviewed in this study, including 172 patients undergoing AC procedure, and 182 patients with PC procedure between June 2007 and May 2012. All patients were given the same postoperative management. The presence and severity of dysphagia were reported during the telephone interviews performed at 1, 3, 6, and 12 months after the procedure. The incidence and risk factors of dysphagia after cervical spine surgery were studied. Results. Of all 354 patients, 12.8% AC and 9.4% PC patients reported dysphagia at early postoperative assessment. The overall incidence for dysphagia at 1, 3, 6 and 12 months were decreased to 9.3%, 7.0%, 4.6% and 3.5% in AC group, and 6.0%, 4.4%, 2.2% and 1.6% in PC group, respectively. Long term use of Neck Collar after surgery may lead to postoperative dysphagia. Other risk factors such as age, gender, BMI, operative time, blood loss, procedure type, revision surgery and operative levels did not significantly influence the incidence of postoperative dysphagia.Conclusions. Postoperative dysphagia is common after anterior and posterior cervical spine surgery. The incidence and severity of dysphagia both decrease over time. Long term use of neck collar after surgery is related of postoperative dysphagia. The neck collar should be worn no longer than four weeks after surgery. Age, gender, BMI, operative time, blood loss, procedure type, revision surgery and operative levels are not risk factors of postoperative dysphagia.

Characterization of dysphagia following anterior cervical spine surgery

“…We found that patients in the early phase (≤2 months) of recovery exhibited significant structural and physiologic pharyngeal swallowing impairment as well as a higher incidence of bolus airway invasion on VFSS as compared to healthy controls and patients in the late phase of recovery (> 2 months). Our findings agree with previous investigations that have revealed a decrease in dysphagic symptoms within the first two months post-ACSS with most patients able to return to normal diets shortly after (Leonard & Belafsky, 2011;Kang et al, 2011;Miles et al, 2019;Yu & Tao, 2020).…”