Sheng Shi1, Xin-Feng Li1, Qi-Tong Zhao1, Li-Li Yang2, Zu-De Liu3, Wen Yuan4. 1. Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China. 2. Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China. 3. Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China. Electronic address: rjliuzd@163.com. 4. Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China. Electronic address: spinewenyuan@126.com.
Abstract
OBJECTIVE: To determine any differences in self-reported dysphagia in patients treated with single-level anterior cervical decompression with different zero-profile implants (arthroplasty vs. arthrodesis) and identify risk factors for postoperative dysphagia. METHODS: A total of 112 patients with 1-level cervical degenerative disc disease were included in the prospective study. The dysphagia conditions and radiologic results were assessed using Bazar dysphagia scoring system, the Swallowing Quality of Life scores, cervical alignment (CA), segmental angle, and prevertebral soft tissues swelling (PSTS). All these parameters were compared before and after surgery in the respective group, which were also compared between the 2 groups. Correlations between the confounding factors and postoperative dysphagia were analyzed. RESULTS: No significant differences existed in preoperative or initially postoperative dysphagia rate and scores between the 2 groups (P > 0.05). However, the dysphagia rate and scores of cervical disc arthroplasty was better than those of fusion at postoperative day 7. Heavy smoker, PSTS change (≥5 mm), or CA change (≥5 degrees) was prone to have postoperative dysphagia. CONCLUSIONS: Postoperative dysphagia remains a common incidence, despite advances in instrumentation technologies. However, cervical disc arthroplasty is superior to anterior cervical discectomy and fusion in ameliorating the symptom of dysphagia in the early postoperative term. Heavy smoker, PSTS change (≥5 mm), and CA change (≥5 degrees) were important predictors of postoperative dysphagia.
OBJECTIVE: To determine any differences in self-reported dysphagia in patients treated with single-level anterior cervical decompression with different zero-profile implants (arthroplasty vs. arthrodesis) and identify risk factors for postoperative dysphagia. METHODS: A total of 112 patients with 1-level cervical degenerative disc disease were included in the prospective study. The dysphagia conditions and radiologic results were assessed using Bazar dysphagia scoring system, the Swallowing Quality of Life scores, cervical alignment (CA), segmental angle, and prevertebral soft tissues swelling (PSTS). All these parameters were compared before and after surgery in the respective group, which were also compared between the 2 groups. Correlations between the confounding factors and postoperative dysphagia were analyzed. RESULTS: No significant differences existed in preoperative or initially postoperative dysphagia rate and scores between the 2 groups (P > 0.05). However, the dysphagia rate and scores of cervical disc arthroplasty was better than those of fusion at postoperative day 7. Heavy smoker, PSTS change (≥5 mm), or CA change (≥5 degrees) was prone to have postoperative dysphagia. CONCLUSIONS:Postoperative dysphagia remains a common incidence, despite advances in instrumentation technologies. However, cervical disc arthroplasty is superior to anterior cervical discectomy and fusion in ameliorating the symptom of dysphagia in the early postoperative term. Heavy smoker, PSTS change (≥5 mm), and CA change (≥5 degrees) were important predictors of postoperative dysphagia.
Authors: Yushi Hoshino; Ichiro Okano; Erika Chiapparelli; Stephan N Salzmann; Courtney Ortiz Miller; Jennifer Shue; Andrew A Sama; Frank P Cammisa; Federico P Girardi; Alexander P Hughes Journal: Eur Spine J Date: 2020-06-07 Impact factor: 3.134
Authors: Julian L Gendreau; Lily H Kim; Payton N Prins; Marissa D'Souza; Paymon Rezaii; Arjun V Pendharkar; Eric S Sussman; Allen L Ho; Atman M Desai Journal: Global Spine J Date: 2019-11-21