The effect of the difference in C2-7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the Zero-P Implant System

Abstract

Objectives: To investigate the effect of the difference in C2-7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.Methods: A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2-7 angle (dC2-7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.Results: In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2-7A were significantly different between the two groups (P<0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2-7A (P>0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2-7A were significantly associated with the incidence of dysphagia (P<0.05).Conclusions: The postoperative C2-7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.

Facet Distraction and Dysphagia: A Prospective Evaluation of This Common Postoperative Issue Following Anterior Cervical Spine Surgery

“…Moreover, while we independently evaluated the impact of distraction at the disk space and facets on dysphagia, we did not evaluate the impact of this distraction on overall sagittal alignment, which has the potential to impact rates of dysphagia postoperatively. 45,46…”

“…In addition, while the interrater and intrarater reliability was strong, and the consistency of measurements was below 0.1 mm, the inherent variability in these small measurements may mask the true distraction when measuring small distances with a mean of 0.77 mm. Moreover, while we independently evaluated the impact of distraction at the disk space and facets on dysphagia, we did not evaluate the impact of this distraction on overall sagittal alignment, which has the potential to impact rates of dysphagia postoperatively 45,46…”