Related factors to dysphagia after anterior cervical spine surgery

English Keywords:Dysphagia  Cervical spine  Anterior cervical spine surgery  Related factors

English Abstract:

  【Abstract】 Objectives: To evaluate the related factors of dysphagia following anterior cervical spine surgery．Methods: 135 cases undergoing anterior cervical spine surgery from August 2008 to July 2010 were followed up. There were 82 males and 53 fema1es, with a mean age of 58.2 years(range，32 to 80 years)． Of these 135 patients, 58 had cervical spondylotic myelopathy(CSM), 32 had cervical radiculopathy, 18 had cervical myeloradiculopathy, 27 had ossification posterior longitudinal ligament(OPLL). All cases were treated by the same surgical group including anterior cervical discectomy and fusion(ACDF), and/or anterior cervical compectomy and fusion(ACCF), and total disc replacement(TDR). 135 patients were reviewed retrospectively on their postoperative dysphagia. All cases with dysphgia accepted Methylprednisolone intravenously and correspondant therapy． Results: 135 cases were followed up, and 36(26.7％) of them had postoperative dysphagia, including 11 males and 25 females． The age of patients with dysphagia ranged from 42 to 80 years, average age was 59.6. The rest age ranged from 32 to 76, the average age was 52.3, which was more significant compared to the former(P<0.05). 35 cases with postoperative dysphagia had titanium plates placement, while 1 case with cervical artificial disc replacement had dysphagia. The rate of dysphagia in multi-level group was significantly higher than the single-level and two-level group. In the group with surgical level related to C2 and C3, dysphagia rate was 26.1%. In the group with surgical level related to C4 and C5, dysphagia rate was 28.4%. In the group with surgical level related to C6 and C7, dysphagia rate significance between each two groups(P>0.05). There was no statistical significance in the surgical time, blood loss or hospital day(P>0.05). After 6 month follow-up, 35 cases(97.2％) had dysphagia cured or improved． While 1 case had improvement at 1 year follow-up． Conclusions: Female, elder, titanium plating and multiple surgical level numbers may be associated with postoperative dysphagia. As a result, clinicians should pay more attention to this complication and make proper intervention．