Risk Factors for Dysphagia After Anterior Cervical Spine Surgery

• Published in: Orthopedics (Thorofare, N.J.) Vol. 41; no. 1; pp. e110 - 116
• Main Authors: Li, Zhikun, Li, Gengwu, Chen, Chao, Li, Yifan, Yang, Changwei, Xu, Wei, Zhu, Xiaodong
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.01.2018
• Subjects: Age; Dysphagia; Esophagus; Hospitals; Orthopedics; Patients; Risk factors; Surgery; Titanium; Vertebrae; China
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20171213-04

This study evaluated the risk factors for dysphagia after anterior cervical spine surgery by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia. The patients underwent anterior cervical spine surgery and were followed for at least 6 months. Sex, age, tracheal mobility, smoking history, implant type, C3 anterior vertebral soft tissue swelling, narrowest esophageal distance before internal fixation, cervical curvature, operative time, occurrence of fusion, number of operative segments, and highest vertebral segment were recorded. Chi-square test and logistic regression were performed to analyze the predictive value of each dimension for dysphagia. A total of 158 patients were included in this study. The mean C3 anterior vertebral soft tissue swelling was 8.8±4.5 mm, the mean narrowest esophageal distance before internal fixation was 6.9±4.4 mm, and the mean operative time was 78.5±39.2 minutes. Chi-square test results showed that age 60 years and older, female sex, internal fixation with titanium plate/titanium mesh, narrowest esophageal distance before internal fixation of less than 5 mm, and 3 operative segments indicated a relatively high incidence of dysphagia. Logistic regression analyses showed that age, sex, implant type, narrowest esophageal distance before internal fixation, and number of operative segments were all risk factors predictive of postoperative dysphagia. The area under the receiver operating characteristic curve was 0.872. Age 60 years and older, female sex, internal fixation with titanium plate/titanium mesh, narrowest esophageal distance before internal fixation of less than 5 mm, and 3 operative segments were risk factors for dysphagia after anterior cervical surgery. The regression equation may be used to predict the occurrence of dysphagia. [Orthopedics. 2018; 41(1):e110-e116.].