Author: Kalb, S.; Reis, M.T.; Cowperthwaite, M.C.; Fox, D.J.; Lefevre, R.; Theodore, N.; Papadopoulos, S.M.; Sonntag, V.K.H.
Description:
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.
Subject headings: Adult; Age Factors; Aged; Bone Plates; Braces; Cervical Vertebrae–surgery; Decompression, Surgical–adverse effects; Deglutition Disorders–epidemiology, etiology; Disability Evaluation; Ethnic Groups; Female; Humans; Male; Middle Aged; Neurosurgical Procedures–adverse effects; Postoperative Complications–epidemiology, etiology; Questionnaires; Reoperation; Risk Factors; Sex Factors; Smoking–adverse effects; Spine–surgery
Publication year: 2012
Journal or book title: World Neurosurgery
Volume: 77
Issue: 1
Pages: 183-187
Find the full text : http://www.sciencedirect.com/science/article/pii/S1878875011008709
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Type: Journal Article
Serial number: 300