What Is the Incidence and Severity of Dysphagia After Anterior Cervical Surgery?
Summary of "What Is the Incidence and Severity of Dysphagia After Anterior Cervical Surgery?"
BACKGROUND:
Existing studies suggest a relatively high incidence of dysphagia after anterior cervical decompression and fusion (ACDF). The majority of these studies, however, are retrospective in nature and lack a control group. QUESTIONS/
PURPOSES:
We therefore (1) prospectively determined the incidence and severity of dysphagia after ACDF using lumbar decompression patients as a control group; and (2) determined which factors, if any, are associated with increased postoperative dysphagia.
METHODS:
Patients undergoing either one- or two-level ACDF (n = 38) or posterior lumbar decompression (n = 56) were prospectively followed. Baseline patient characteristics were recorded. A dysphagia questionnaire was administered preoperatively and during the 2-week, 6-week, and 12-week postoperative visits. We found no differences in patient age, body mass index, or the preoperative incidence and severity of dysphagia between the cervical and lumbar groups. We compared the incidence and severity of dysphagia between the patients who had cervical and lumbar surgery.
RESULTS:
Postoperatively, 71% of patients having cervical spine surgery reported dysphagia at 2 weeks followup. This incidence decreased to 8% at 12 weeks followup. The incidence and severity of dysphagia were greater in the cervical group at 2 and 6 weeks followup with a trend toward greater dysphagia at 12 weeks followup. Body mass index, gender, location of surgery, and the number of surgical levels were not related to the risk of developing dysphagia. We observed a correlation between operative time and the severity of postoperative dysphagia.
CONCLUSIONS:
Dysphagia is common after ACDF. The incidence and severity of postoperative dysphagia decreases over time, although symptoms may persist at least 12 weeks after surgery. LEVEL OF
EVIDENCE:
Level II, prospective, comparative study. See Guidelines for Authors for a complete description of levels of evidence.
Affiliation
The Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA, jrihno16@yahoo.com.
Journal Details
This article was published in the following journal.
Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21140251
- DOI: http://dx.doi.org/10.1007/s11999-010-1731-8
Medical and Biotech [MESH] Definitions
Deglutition Disorders
Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.
Plummer-vinson Syndrome
A syndrome of DYSPHAGIA with IRON-DEFICIENCY ANEMIA that is due to congenital anomalies in the ESOPHAGUS (such as cervical esophageal webs). It is known as Patterson-Kelly syndrome in the United Kingdom.
Neck Dissection
Dissection in the neck to remove all disease tissues including cervical LYMPH NODES and to leave an adequate margin of normal tissue. This type of surgery is usually used in tumors or cervical metastases in the head and neck. The prototype of neck dissection is the radical neck dissection described by Crile in 1906.
Cervical Plexus
A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm.
Cervical Length Measurement
A parameter usually used in PRENATAL ULTRASONOGRAPHY to measure the length of the uterine neck (CERVIX UTERI). Cervical length or its shortening is used to identify and prevent early cervical opening and PRETERM BIRTH.
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