Meta-analysis of risk factors for dysphagia after anterior cervical spine surgery

English Keywords:Anterior cervical spine surgery  Dysphagia  Risk factors  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To systematically evaluate the risk factors for dysphagia after anterior cervical spine surgery(ACSS), identify the independent risk factors, and to provide a guidance for the prevention and treatment of perioperative complications. Methods: A total of 8 databases including Wanfang, CBM, CNKI, VIP, PubMed, Embase, Cochrane Library, and Web of Science were searched for case-control and cohort studies about the risk factors of dysphagia after ACSS from the establishment of each database to July 15, 2023. Newcastle-Ottawa scale(NOS) was adopted to evaluate the qualities of the included literaure. Related data such as the first author, publication year, research type, sample size, assessment method, evaluation time, and risk factors were extracted and Stata 12 software was used to do the meta-analysis. Results: 29 articles were included, consisting of 4 cohort studies and 25 case control studies. All of the articles were of high quality. The total sample size of patients with dysphagia after ACSS was 89571 and the number of patients in the control group was 3092967. Age(OR=1.093, 95%CI: 1.067-1.120), female(OR=2.419, 95%CI: 1.654-3.539), diabetes mellitus(OR=2.733, 95%CI: 2.240-3.333), disease duration(OR=4.259, 95%CI: 2.458-7.381), levels of surgery(OR=1.791, 95%CI: 1.718-1.868), operative level(OR=2.332, 95%CI: 1.812-3.003), operative time(OR=1.434, 95%CI: 1.110-1.852), plate(OR=2.188, 95%CI: 1.413-3.175) and revision surgery(OR=2.687, 95%CI: 2.316-3.119) were related to dysphagia after ACSS, while smoking(OR=1.323, 95%CI: 0.852-2.056), hypertension(OR=1.006, 95%CI: 0.591-1.713), body mass index(BMI) (OR=1.037, 95%CI: 0.929-1.159), cervical disc arthroplasty(OR=0.577, 95%CI: 0.085-3.943) and difference between postoperative and preoperative C2-7 angles(dC2-7)＞5°(OR=1.716, 95%CI: 0.925-3.183) were not. Conclusions: Patients who are female, old aged, with long preoperative disease duration and diabetes mellitus, undergoing double or multi-level surgery, upper cervical spine surgery, and revision surgery, prolonged operation time, and use of plate, are prone to have dysphagia after ACSS.