Dysphagia After Anterior Cervical Spine Surgery

Siska, Peter A.; Ponnappan, Ravi K.; Hohl, Justin B.; Lee, Joon Y.; Kang, James D.; Donaldson, William F.

doi:10.1097/brs.0b013e31822340f2

Cited by 85 publications

(22 citation statements)

References 20 publications

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“…Condition-specific measures were heterogeneous and included: esophageal cancer 19–23 , oropharyngeal dysphagia related to cancer 24–27 , oropharyngeal dysphagia 28–30 , eosinophilic esophagitis 13, 16, 31 , dysphagia related to anterior spine surgery 32, 33 , Parkinson’s disease 34, 35 , benign esophageal disease 12 , total laryngectomy-related dysphagia 36 , esophageal stricture 14 , achalasia 18 , esophageal disorders 37 , multiple sclerosis 38 , and systemic sclerosis 39 . Seven were designed to assess patients with general dysphagia 15, 40–45 , and one was a screening tool for dysphagia among geriatric patients 23 .…”

Section: Resultsmentioning

confidence: 99%

Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation

Patel¹,

Sharda²,

Hovis

et al. 2017

Diseases of the Esophagus

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Objective Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to 1) identify all currently available measures and 2) to evaluate each for the presence of important measurement properties that would affect their applicability. Design MEDLINE via the PubMed interface, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument database were searched using relevant vocabulary terms and key terms related to PRO measures and dysphagia. Three independent investigators performed abstract and full text reviews. Each study meeting criteria was evaluated using an 18-item checklist developed a priori that assessed multiple domains: 1) conceptual model, 2) content validity, 3) reliability, 4) construct validity, 6) scoring and interpretation, and 7) burden and presentation. Results Of 4950 abstracts reviewed, a total of 34 dysphagia-related PRO measures (publication year 1987 – 2014) met criteria for extraction and analysis. Several PRO measures were of high quality (MADS for achalasia, SWAL-QOL and SSQ for oropharyngeal dysphagia, PROMIS-GI for general dysphagia, EORTC-QLQ-OG25 for esophageal cancer, ROMP-swallowing for Parkinson’s disease, DSQ-EoE for eosinophilic esophagitis, and SOAL for total laryngectomy-related dysphagia). In all, 17 met at least one criterion per domain. Thematic deficiencies in current measures were evident including: 1) direct patient involvement in content development, 2) empirically justified dimensionality, 3) demonstrable responsiveness to change, 4) plan for interpreting missing responses, and 5) literacy level assessment. Conclusion This is the first comprehensive systematic review assessing developmental properties of all available dysphagia-related PRO measures. We identified several instruments with robust measurement properties in multiple diseases including achalasia, oropharyngeal dysphagia, post-surgical dysphagia, esophageal cancer, and dysphagia related to neurological diseases. Findings herein can assist clinicians and researchers in making more informed decisions in selecting the most fundamentally sound PRO measure for a given clinical, research, or quality initiative.

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Section: Resultsmentioning

confidence: 99%

Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation

Patel¹,

Sharda²,

Hovis

et al. 2017

Diseases of the Esophagus

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“…[16–20] At present, it is not clear about the mechanism of dysphagia after ACDF. The anterior cervical plate can increase interbody fusion rates and stability, restore or maintain cervical lordosis and prevent interbody graft subsidence or dislocation in ACDF surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[16] A review of literature yields a largely varied incidence of postoperative dysphagia, ranged from 2% to 67%. [17–20] However, the pathophysiology of dysphagia has not been well understood. A series of risk factors such as reoperation, long operation time, are associated with an increase in postoperative dysphagia incidence.…”

Section: Introductionmentioning

confidence: 99%

Different surgical approaches for the treatment of adjacent segment diseases after anterior cervical fusion

Wang

Wang²,

Miao³

et al. 2017

Medicine

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Studies in the literature have not delineated the surgical approaches of symptomatic adjacent segment diseases (ASDs) in patients undergoing reoperation after an initial anterior cervical fusion (ACF). The purpose of this study was to determine the optimal surgical approaches of ASD and the incidence of the dysphagia after reoperation.This was a retrospective study of 49 patients with ASD after an initial ACF surgery, which had undergone a reoperation at our medical center between January 2010 and December 2014. The surgical approaches were used by anterior cervical discectomy and fusion (ACDF), ACDF with the Zero-profile device, laminoplasty, and laminectomy with internal fixation. Patients were classified according to the different surgical approaches of anterior (n = 38) versus posterior (n = 11) groups and ACDF (n = 25) versus Zero-P (n = 13) groups. Clinical evaluations were performed preoperatively and repeated in 24 months after operation.This retrospective study included 26 men and 23 women with a mean age at revision surgery of 54.3 years and ASD onset time of 7.3 years. The patients were followed up with an average of 4.1 years. The reoperation rate was 5.4% in this study. The Japanese Orthopaedic Association (JOA), Neck Disability Index (NDI), and visual analogue scale (VAS) scores demonstrated significant improvements compared with preoperative in both anterior and posterior groups (P < .05). However, there were no differences between the 2 groups (P > .05). The operation time of ACDF group was more than Zero-P group, with significant differences (P < .05). However, there were no differences in JOA, NDI, and VAS scores between the ACDF and Zero-P groups pre- and postoperative (P > .05). A total of 12 (24.5%) patients had dysphagia after reoperation. The incidence of dysphagia in Zero-P group (1/13) was less than ACDF group (11/25), with significant differences (P < .05). There were no cases of major neurological or vascular complications, and wound complications.The clinical situation, initial operation, and secondary preoperative imaging findings were analyzed comprehensively, anterior or posterior approach were chosen, which can effectively relieve spinal cord compression and improve spinal cord function. In ACDF with the Zero-profile device surgery, there was no need to remove the previous internal fixation, shorten the operation time, and reduce the incidence of postoperative dysphagia.

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“…Postoperative dysphagia, which is usually temporary, is the most common complication after anterior cervical spine surgery, and incidence is 1%–79%, depending on the study design (12345678). On-going studies are being conducted to devise methods to reduce postoperative dysphagia, such as use of methylprednisolone, pressure control of endotracheal tube cuff, and metal bar selection.…”

Section: Introductionmentioning

confidence: 99%

Swallowing Function Defined by Videofluoroscopic Swallowing Studies after Anterior Cervical Discectomy and Fusion: a Prospective Study

et al. 2016

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This study evaluated factors related to swallowing dysfunction after anterior cervical discectomy and fusion (ACDF) using videofluoroscopic swallowing studies (VFSS). Preoperative and postoperative VFSSs were done with 5 mL diluted barium. Oral transit time, pharyngeal delay time, pharyngeal response time (PRT), and pharyngeal transit time were measured. Hyoid bone movement and upper esophageal sphincter (UES) diameter were measured serially. Thickness of prevertebral soft tissue was measured from digitized VFSS images. In results, 12 of 20 patients showed abnormal postoperative VFSS findings. PRT decreased significantly after surgery. Hyoid bone movement did not change significantly after surgery. The maximal distance of UES opening decreased significantly after surgery, and the higher the level of surgery (C3 > C4 > C5 > C6), the greater the decrease in maximal distance of the UES opening after surgery. The time to widest opening of the UES was prolonged significantly. At the C3 and C4 levels, the change in prevertebral soft tissue thickness of patients with VFSS abnormalities was significantly greater than those without abnormalities. In conclusion, patients after ADCF with their highest surgery level at C3 and C4 showed more abnormal VFSS findings, significantly increased soft tissue thickness, and decreased maximal distance of UES opening. VFSS provided objective data related with swallowing dysfunction after ACDF.

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Dysphagia After Anterior Cervical Spine Surgery

Cited by 85 publications

References 20 publications

Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation

Patient-reported outcome measures in dysphagia: a systematic review of instrument development and validation

Different surgical approaches for the treatment of adjacent segment diseases after anterior cervical fusion

Swallowing Function Defined by Videofluoroscopic Swallowing Studies after Anterior Cervical Discectomy and Fusion: a Prospective Study

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