Risk Factors of Dysphagia after Anterior Decompression and Fusion Surgery for Degenerative Cervical Spine

Abstract

Introduction: Dysphagia is one of the most serious complications after anterior cervical decompression and fusion (ACDF) surgeries; however, there are few reports on the risk factors that lead to this complication. The purpose of this study was to clarify the risk factors of dysphagia after ACDF.

Methods: A total of 802 patients who underwent ACDF at our institution participated in the study. Patients who needed intravenous or tube feeding > 2 days after the third day were classified under the dysphagia (D) group. We compared sex, age, diagnosis, operative levels, C2 involvement, operative time, blood loss, and cerebrospinal fluid (CSF) leakage between D and no dysphagia (N) groups.

Results: Dysphagia was recognized in 21 of 802 patients. The D group had higher age, ossification of the posterior longitudinal ligament (OPLL) ratio, operative levels, C2 involvement, longer operative time, more bleeding, and more CSF leakage than the N group. Furthermore, multivariable analysis revealed that high age and C2 involvement were independent risk factors.

Conclusions: We found high age, OPLL ratio, multilevel surgery, C2 involvement, longer operative time, high bleeding, and CSF leakage to be risk factors of dysphagia after ACDF surgery. High age and C2 involvement were the most important factors among them.