Dysphagia after anterior cervical discectomy and interbody fusion
Authors:
R. Opšenák; B. Kolarovszki; M. Benčo; J. Šutovský; R. Richterová; P. Snopko
Authors place of work:
Neurochirurgická klinika JLF UK a UN Martin, Slovenská republika
Published in the journal:
Gastroent Hepatol 2017; 71(2): 150-155
Category:
Clinical and Experimental Gastroenterology: Original Article
doi:
https://doi.org/10.14735/amgh2016csgh.info17
Summary
Introduction:
Dysphagia is a common finding after anterior cervical discectomy. The incidence and the severity of swallowing disorders after surgery vary and depend on many factors.
Patients and Methods:
A single-center, prospective, open study, with a follow-up period of 6 months, was used to evaluate 66 patients after one- or two-level anterior cervical discectomy and fusion (ACDF) with cages Zero-P VA® or ROI-C® in the period from May 2012 to August 2014. The severity of swallowing disorders was assessed using the Bazaz-Yoo dysphagia score before surgery, and at 6 weeks, 3 months, and 6 months after surgery. Authors investigated the influence of factors such as preexisting dysphagia, gender, number of operated segments, smoking, and duration of surgery on the incidence of postoperative dysphagia. The correlation between the duration of surgery and severity of postoperative dysphagia was also examined.
Results:
In the whole group of patients, dysphagia was present in 15% of patients before surgery, and 56% of patients reported swallowing difficulties 6 weeks after surgery, 32% of patients at 3 months after surgery, and 18% of patients at 6 months after surgery. No patient reported severe dysphagia during the whole period of observation. There was no significant relationship between the incidence of preexisting and postoperative dysphagia. Preexisting swallowing difficulties have been reported by 3% of smokers and 24% of non-smokers, and the difference was significant (p < 0.05). Throughout the observation period, no significant relationship between gender, smoking, number of operated segments, duration of surgery, and the incidence of postoperative dysphagia was observed. There was no correlation between the duration of surgery and the severity of postoperative dysphagia throughout the observation period.
Conclusion:
Most patients experienced mild swallowing disorders 6 weeks after ACDF, but not during the postoperative period. Preexisting dysphagia, gender, smoking, number of operated segments, and duration of surgery had no influence on the incidence of dysphagia after ACDF. The duration of the surgery did not correlate with the severity of dysphagia after surgery.
Key words:
cervical spine – discectomy – dysphagia – risk factors
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.
Submitted:
17. 1. 2016
Accepted:
5. 7. 2016
Zdroje
1. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976) 2002; 27 (22): 2453–2458.
2. Frempong-Bodau A, Houten JK, Osborn B et al. Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postperative assesment. J Spinal Disord Tech 2002; 15 (5): 362–368.
3. Smith-Hammond CA, New KC, Pietrobon R et al. Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures. Spine (Phila Pa 1976) 2004; 29 (13): 1441–1446.
4. Yue WM, Brodner W, Highland TR. Persistent swallowing and voice problems after anterior cervical discectomy anf fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J 2005; 14 (7): 677–682.
5. Martin RE, Neary MA, Diamant NE. Dysphagia following anterior cervical spine surgery. Dysphagia 1997; 12: 2–8.
6. Lee MJ, Bazaz R, Furey C et al. Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech 2005; 18 (5): 406–409.
7. Segebarth B, Datta JC, Darden B et al. Incidence of dysphagia comparing cervical arthroplasty and ACDF. SAS Journal 2010; 4 (1): 3–8. doi: 10.1016/j.esas.2009.12.001.
8. Fogel GR and McDonnell MF. Surgical treatment of dysphagia after anterior cervical interbody fusion. Spine J 2005; 5 (2): 140–144.
9. Anderson KK, Arnold PM. Oropharyngeal dysphagia after anterior cervical spine surgery: a review. Global Spine J 2013; 3 (4): 273–286. doi: 10.1055/s-0033-1354253.
10. Pedram M, Castagnera L, Carat X et al. Pharyngolaryngeal lesions in patients undergoing cervical spine surgery trough the anterior approach: contribution of methylprednisolon. Spine J 2003; 12 (1): 84–90.
11. Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention od recurent laryngeal nerve palsies during anterior cervical spine surgery. Spine (Phila Pa 1976) 2000; 25 (22): 2906–2912.
12. Ratnaraj J, Todorov A, McHugh T et al. Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery. J Neurosurg 2002; 97 (2 Suppl 1): 176–179.
13. Stewart M, Johnston RA, Stewart I et al. Swallowing performance following anterior cervical spine surgery. Br J Neurosurg 1995; 9 (5): 605–609.
14. Riley LH 3rd, Skolasky RL, Albert TJ et al. Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study. Spine 2005; 30 (22): 2564–2569.
15. Scholz M, Schnake KJ, Pingel A et al. A new Zero-profile implant for stan-alone anterior cervical interbody fusion. Clin Orthop Relat Res 2011; 469 (3): 666–673. doi: 10.1007/s11999-010-1597-9.
16. Kalb S, Reis MT, Cowperthwaite MC et al. Dysphagia after cervical spine surgery: incidence and risk factors. World Neurosurg 2012; 77 (1): 183–187. doi: 10.1016/j.wneu.2011.07.004.
17. Min Y, Kim WS, Kang SS et al. Incidence of dysphagia and serial videofluoroscopic swallow study findings after anterior cervical discectomy and fusion: a prospective study. Clin Spine Surg 2016; 29 (4): E177–E181. doi: 10.1097/BSD.0000000 000000060.
18. Wu B, Song F, Zhu S. Reasons of dysphagia after operation of anterior cervical decompression and fusion. Clin Spine Surg 2016. In press.
Štítky
Paediatric gastroenterology Gastroenterology and hepatology SurgeryČlánok vyšiel v časopise
Gastroenterology and Hepatology
2017 Číslo 2
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
- Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
Najčítanejšie v tomto čísle
- Ustekinumab – a new biological therapy for patients with Crohn’s disease
- Picoprep® – a clearing agent with a new dosing schedule
- Czech Society of Hepatology guidelines for diagnosis and treatment of acute porphyrias
- Dysphagia after anterior cervical discectomy and interbody fusion