Risk Factors and Assessment Using an Endoscopic Scoring System for Early and Persistent Dysphagia After Anterior Cervical Decompression and Fusion Surgery

Autor: Hiroshi Akaike, Hirotaka Haro, Kensuke Koyama, Kyousuke Hatsushika, Shigeto Ebata, Hiroshi Yokomichi, Keisuke Masuyama, Tetsuro Ohba
Rok vydání: 2020
Předmět:
Adult
Decompression
Male
medicine.medical_specialty
Scoring system
Health Personnel
Kyphosis
Anterior cervical discectomy and fusion
Logistic regression
Severity of Illness Index
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Otolaryngologists
Odds Ratio
otorhinolaryngologic diseases
medicine
Humans
Orthopedics and Sports Medicine
Postoperative Period
Prospective cohort study
Aged
Retrospective Studies
Aged
80 and over
030222 orthopedics
business.industry
Incidence (epidemiology)
Endoscopy
Middle Aged
Decompression
Surgical
medicine.disease
Dysphagia
Spine
Surgery
Spinal Fusion
Otorhinolaryngology
Multivariate Analysis
Cervical Vertebrae
Female
Neurology (clinical)
medicine.symptom
Deglutition Disorders
business
030217 neurology & neurosurgery
Diskectomy
Zdroj: Clinical Spine Surgery: A Spine Publication. 33:E168-E173
ISSN: 2380-0186
DOI: 10.1097/bsd.0000000000000945
Popis: Study design Prospective study. Objectives Preoperative and postoperative dysphagia was evaluated by an otolaryngology doctor and a speech-language-hearing therapist using the eating assessment tool (EAT-10) and Hyodo-Komagane scores. The objective was to achieve a more precise evaluation of the incidence and risk factors of early and persistent dysphagia after anterior cervical discectomy and fusion (ACDF). Summary of background data Although numerous reports have explored the risk factors for dysphagia after ACDF, these factors remain controversial. The main reason for this situation is that the methods for evaluating dysphagia are not adequate or uniform. Materials and methods This study involved a retrospective 47 consecutive patients who had undergone ACDF and been followed up for at least 1 year. Sagittal alignment of the cervical spine was evaluated by a preoperative x-ray. Univariate and multivariate logistic regression analyses were performed to determine risk factors for transient or persistent dysphagia. Results The study showed that 34% of patients developed dysphagia in the early postoperative period and that 25.5% of patients still had persistent dysphagia 1 year postoperatively. 8.5% of patients had already developed dysphagia preoperatively, with a significant positive correlation observed between preoperative and postoperative dysphagia.Aging and smoking were significant risk factors for transient dysphagia. A preoperative cervical kyphotic angle at the C3/C4, C4/C5 disk-level and change in the kyphotic angle at C4/C5 during surgery were significant risk factors of persistent dysphagia 1 year after surgery. Conclusions This is the first study to show dysphagia after anterior cervical spine surgery using the EAT-10 score and Hyodo-Komagane score with endoscopic evaluation. Aging and smoking were significant risk factors for transient dysphagia, while preoperative local kyphosis angles of C3-C4 and C4-C5 and change in the kyphotic angle at C4/C5 during surgery may be a key alignment of risk factors for postoperative persistent dysphagia. Level of evidence Level: III.
Databáze: OpenAIRE
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