A cohort study of the morbidity of combined anterior-posterior cervical spinal fusions: incidence and predictors of postoperative dysphagia
Reinard KA, Cook DM, Zakaria HM, Basheer AM, Chang VW, and Abdulhak MM. A cohort study of the morbidity of combined anterior-posterior cervical spinal fusions: incidence and predictors of postoperative dysphagia. Eur Spine J 2016; 25(7):2068-2077.
European spine journal
PURPOSE: To identify risk factors that may lead to the development of dysphagia after combined anterior and posterior (360°) cervical fusion surgery.
METHODS: A single center, retrospective analysis of patients who had same-day, 360° fusion at Henry Ford Hospital between 2008 and 2012 was performed. Variables analyzed included demographics, medical co-morbidities, levels fused, and degree of dysphagia.
RESULTS: The overall dysphagia rate was 37.7 %. Patients with dysphagia had a longer mean length of stay (p < 0.001), longer mean operative time (p < 0.001), greater intraoperative blood loss (p = 0.002), and fusion above the fourth cervical vertebra, C4, (p = 0.007). There were no differences in the rates of dysphagia when comparing patients undergoing primary or revision surgery (p = 0.554).
CONCLUSION: Prolonged surgery and fusion above C4 lead to higher rates of dysphagia after 360° fusions. Prior anterior cervical fusion does not increase the risk of dysphagia development.
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Cervical Vertebrae; Cohort Studies; Comorbidity; Deglutition Disorders; Female; Humans; Incidence; Male; Middle Aged; Operative Time; Postoperative Complications; Reoperation; Retrospective Studies; Risk Factors; Spinal Fusion; Young Adult