Dysphagia following anterior cervical spine surgery

Johns, Michael M.; Whitesides, Thomas E.

doi:10.1053/j.semss.2004.10.009

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…There are reports on the incidence of postoperative dysphagia based on the surgeon's interpretation or the patient's interpretation. Thus, Johns et al (49) reported that the incidence of dysphagia was 11% when based on the physicians' notes, while it was 57% when the patients were surveyed. According to Dettori et al (67) a patient's reported outcome has been shown to be more reliable, valid, and preferable.…”

Section: Dysphagiamentioning

confidence: 99%

“…Implant related complications have also been reported in the literature (20,27,(40)(41)(42)(43)(44). The list also includes functional complications such as dysphagia, dysphonia, and difficulty in swallowing (7,(45)(46)(47)(48)(49)(50)(51). Although the vast majority of these complications are of minor clinical impact, there are extremely rare occasions that the outcome of a complication may be troublesome or even fatal.…”

Section: Introductionmentioning

confidence: 99%

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Anterior cervical spine surgery-associated complications in a retrospective case-control study

Τάσιου¹,

Giannis²,

Brotis³

et al. 2017

J. Spine Surg.

117

113

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Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration.The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded.The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF).Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

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Section: Dysphagiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Τάσιου¹,

Giannis²,

Brotis³

et al. 2017

J. Spine Surg.

117

113

View full text Add to dashboard Cite

show abstract

“…Domestic studies concerning the mechanisms of postoperative dysphagia development in short-and long-term outcomes after cervical spine surgery were relatively few. Many potential risk factors have been reported, including age 1,2 , gender 3,4 , intraoperative esophagus traction 5,6 , long segmental surgery 7,8 , postoperative persistent pain 9,10 , prolonged procedure time 11 , high surgical position 12 , revision surgery 13 , esophageal intubation 14 , and massive blood loss 15 . In addition, other risk factors were associated with dysphagia development such as thickness of internal plate 16 , intraoperative injury of esophagus 17 , postoperative cervical hematoma formation 18 , the use of BMP-2 19 , postoperative soft swelling 20 , scar formation and tissue adhesion 21 , internal compression of the esophagus [22][23][24][25] and recurrent laryngeal nerve injury [22][23][24][25] .…”

Section: Introductionmentioning

confidence: 99%

A Correlation Analysis Between Postoperative Dysphagia and Change of C2-C7 Angle after Anterior Cervical Spine Surgery

Tao

2021

Preprint

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Background. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities in clinical practice. Studies suggest that excessive O-C2 angle change at occipital-cervical fusion causes the oropharyngeal volume reduction leading to severe dysphagia and even respiratory distress after operation. However, rare study has accessed the impact of C2-C7 angle change on the occurrence of dysphagia after anterior cervical spinal surgery. Methods. From June 2007 to May 2010, A total of 198 patients was treated with anterior cervical decompression and plate fixation and 12 months follow-up was completed in 172 patients. Within the same session, a total of 154 patients underwent anterior cervical disc replacement and at least 1-year follow-up was completed in 98 patients. All 270 patients who participated in this study completed a questionnaire (Bazaz dysphagia questionnaire) after telephone follow-up including the onset and time of appearance of dysphagia, symptom relief, treatment plan and so on. To determine whether excessive cervical lordosis change (change of C2-C7 angle) and other risk factors were associated with the dysphagia symptom, all patients were divided into the dysphagia group and the control group, followed over 12 months.Results. The results showed that 12.8% presented with postoperative dysphagia in anterior cervical discectomy and fusion (ACDF) group and 5.1% in cervical disc replacement (CDR) group. According to the regression equation, the excessive change of C2-C7 angle can significantly increase the incidence rate of postoperative dysphagia. The incidence rate of postoperative dysphagia in patients whose C2-C7 angle change more than 5 degree was significantly greater than patients less than 5 degree. Sex, age, BMI, operation time, blood loss, surgery approach (anterior/posterior), revision ratio, the number of surgical segments, the highest surgical segment, and C3 segment included or not cannot affect the occurrence of dysphagia. Conclusions. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities. Cervical lordosis change is an important influencing factor on the occurrence of dysphagia after anterior cervical spine surgery.

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The Role of C2–C7 and O–C2 Angle in the Development of Dysphagia After Cervical Spine Surgery

Tian

2012

Dysphagia

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Dysphagia is a known complication of cervical surgery and may be prolonged or occasionally serious. A previous study showed that dysphagia after occipitocervical fusion was caused by oropharyngeal stenosis resulting from O-C2 (upper cervical lordosis) fixation in a flexed position. However, there have been few reports analyzing the association between the C2-C7 angle (middle-lower cervical lordosis) and postoperative dysphagia. The aim of this study was to analyze the relationship between cervical lordosis and the development of dysphagia after anterior and posterior cervical spine surgery (AC and PC). Three hundred fifty-four patients were reviewed in this retrospective clinical study, including 172 patients who underwent the AC procedure and 182 patients who had the PC procedure between June 2007 and May 2010. The presence and duration of postoperative dysphagia were recorded via face-to-face questioning or telephone interview performed at least 1 year after the procedure. Plain cervical radiographs before and after surgery were collected. The O-C2 angle and the C2-C7 angle were measured. Changes in the O-C2 angle and the C2-C7 angle were defined as dO-C2 angle = postoperative O-C2 angle - preoperative O-C2 angle and dC2-C7 angle = postoperative C2-C7 angle - preoperative C2-C7 angle. The association between postoperative dysphagia with dO-C2 angle and dC2-C7 angle was studied. Results showed that 12.8 % of AC and 9.4 % of PC patients reported dysphagia after cervical surgery. The dC2-C7 angle has considerable impact on postoperative dysphagia. When the dC2-C7 angle is greater than 5°, the chance of developing postoperative dysphagia is significantly greater. The dO-C2 angle, age, gender, BMI, operative time, blood loss, procedure type, revision surgery, most cephalic operative level, and number of operative levels did not significantly influence the incidence of postoperative dysphagia. No relationship was found between the dC2-C7 angle and the degree of dysphagia. We conclude that postoperative dysphagia is common after cervical surgery. The dC2-C7 angle may play an important role in the development of dysphagia in both anterior and posterior cervical spine surgery. Intraoperative measurement of the dC2-C7 angle is practical and essential in avoiding inadvertent postoperative dysphagia.

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Dysphagia following anterior cervical spine surgery

Cited by 5 publications

References 29 publications

Anterior cervical spine surgery-associated complications in a retrospective case-control study

Anterior cervical spine surgery-associated complications in a retrospective case-control study

A Correlation Analysis Between Postoperative Dysphagia and Change of C2-C7 Angle after Anterior Cervical Spine Surgery

The Role of C2–C7 and O–C2 Angle in the Development of Dysphagia After Cervical Spine Surgery

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