The Relationship Between Increased Intervertebral Disc Height (IDH) and Development of Postoperative Dysphagia After Single-level Anterior Cervical Discectomy and Fusion (ACDF) — A retrospective Study of 217 Cases

Abstract

Background: One goal of the ACDF is to restore the loss of intervertebral disc height (IDH) results from the degenerative process. However, the effect of IDH on postoperative dysphagia after ACDF remain unclear. Methods: 217 consecutive patients after single-level ACDF were enrolled. Based on the results of a one-year telephone follow-up, the patients were divided into dysphagia group and non-dysphagia group. Radiologically, IDH, spinous process distance (SP) of the operated segment and C2-7 angle (C2-7A) were measured preoperatively and postoperatively. The relationship between changes of above radiological parameters and the development of dysphagia was analyzed. Results: 63 cases exhibited postoperative dysphagia. The mean changes in IDH, SP and C2-7A were 2.84 mm, -1.54 mm, and 4.82 degrees, respectively. Change of IDH (P=0.001) and change of C2-7A (P=0.000) showed significant differences between dysphagia and non-dysphagia patients. Increased IDH and increased C2-7A (P=0.037 and 0.003, respectively) significantly and independently influenced the incidence of postoperative dysphagia. When change of IDH ≥ 3 mm, the chance of developing postoperative dysphagia of this patient is significantly greater. No significant relationship was observed between change of spinous process distance (SP) and the incidence of dysphagia. Conclusion: The change of IDH could be regarded as a predictive factor for postoperative dysphagia after single-level ACDF.