Dysphagia after anterior cervical discectomy and interbody fusion: prospective study with follow-up 1 year

Abstract

Introduction: Dysphagia is a common finding after anterior cervical discectomy. The incidence and severity of swallowing disorders are variable and depend on many factors. Methods: 73 patients after 1- or 2-level anterior cervical discectomy and fusion /ACDF/ were enrolled in prospective, single- center study. The severity of dysphagia was evaluated by the Bazaz-Yoo dysphagia score before surgery and 6 weeks, 3, 6 and 12 months after surgery. The impact of factors such as sex, age, number of operated segments, smoking, gastroesophageal reflux disease, hypertension, duration of surgery and pre-existing dysphagia on the incidence of dysphagia after surgery was verified. The correlation between the duration of surgery and severity of postoperative dysphagia, and similarly between the age and severity of preoperative and postoperative dysphagia was studied.
Results: Dysphagia was present in 22% patients within 12 months after surgery. No patient reported severe dysphagia. No significant relationship was demonstrated between sex, age, number of operated segments, pre-existing dysphagia, gastroesophageal reflux disease, hypertension and the incidence of dysphagia after surgery. Smokers showed a significantly lower incidence of dysphagia before surgery and within 12 months after ACDF (p<0.05). The duration of surgery over 90 minutes significantly increased the incidence of dysphagia within 3 months after ACDF (p<0.05). No significant correlation was confirmed between the duration of surgery, age and severity of postoperative dysphagia.
Conclusion: Factors such as pre-existing dysphagia, sex, age, number of operated segments, gastroesophageal reflux disease and hypertension have no impact on the incidence of dysphagia after ACDF. Duration of surgery is a risk factor within 3 months after ACDF.