A comparison of anterior artificial disc insertion and anterior cervical discectomy and fusion in postoperative dysphagia

English Keywords:Anterior artificial disc insertion  Anterior cervical discectomy and fusion  Dysphagia

English Abstract:

  【Abstract】 Objectives: To evaluate the influence of anterior artificial disc insertion(AADI) and anterior cervical discectomy and fusion(ACDF) on postoperative dysphagia. Methods: 98 patients undergoing one-level and two-level AADI and ACDF were retrospectively reviewed in this study. There were 53 patients in group A who underwent AADI and 45 patients in group B who underwent ACDF. The operation time and blood loss were recorded. The dysphagia rate, Swallowing-Quality of Life(SWAL-QOL) score and the thickness of prevertebral soft tissue at each follow-up were compared.　Results: The operation time was significantly lower in group A(85.66±11.84min) than that of group B(93.78±14.81min)(P<0.05). The dysphagia rate and thickness of prevertebral soft tissue thickness were significantly lower in group A at 48 hours and 2 months postoperatively(30.19%,　3.77%,　10.99±1.66mm, 10.17±1.87mm) than that of group B(51.11%, 15.56%, 11.92±1.59mm,　11.45±1.59mm)(P<0.05). The SWAL-QOL score of group A(59.20±7.23, 63.77±3.37) was significantly higher at 48 hours and 2 months postoperatively than that of group B(53.91±8.99, 62.07±4.51)(P<0.05）. No significant difference between groups were observed at 6 month follow-up. Conclusions: AADI is associated with a less operation time, a less irritation to prevertebral soft tissue and a lower dysphagia rate at the first several months postoperatively.