Reasons of Dysphagia After Operation of Anterior Cervical Decompression and Fusion.

STUDY DESIGN: Retrospective study.

OBJECTIVE: To analyze the reasons, clinical manifestation, risk factors, prevention and treatment of dysphagia after operation of anterior cervical decompression and fusion.

SUMMARYOF BACKGROUND DATA: Dysphagia is one of severe complications after anterior cervical decompression and fusion. There were a few studies about reasons and prevention of dysphagia.

METHODS: We retrospectively reviewed medical charts of patients underwent anterior cervical decompression and fusion in our hospital from January 2012 to December 2012. Clinical symptom of dysphagia was recorded at the perioperative period, third and sixth month of the follow-up after surgery and assign according to the Bazaz dysphagia score. We analyzed the reasons and risk factors leading to dysphagia and tried to find effective programs of prevention and treatment.

RESULTS: There were 358 patients underwent anterior cervical decompression and fusion. Of 358 patients, 39 patients including 14 males and 25 females complained dysphagia. The mean aged was 46.8 years with the age from 38 to 67 years old. Clinical manifestation of dysphagia included difficulty to swallow, swallowing pain, sticky throat feeling and choking. All the patients were followed up over six months. The incidences of dysphagia were 10.9%, 6.4%, 2.7% respectively at 1-5 days, three months and six months after surgery. There was no severe dysphagia at three months after surgery. Mild or moderate dysphagia slightly affected the quality of life. Logistic regression showed multilevel cervical spine and high-level cervical spine surgeries are high risk factors for postoperative dysphagia.

CONCLUSIONS: Dysphagia is common complication of anterior cervical decompression and fusion. Causes of leading to dysphagia are multilevel cervical spine and upper cervical spine surgeries. Using methylprednisolone and careful operating can reduce the incidence and receive a good prognosis.