Prediction and Prevention of Postoperative Dysphagia by Preoperative ST Intervention in Anterior Cervical Decompression and Fusion

Abstract

Introduction: Postoperative dysphagia is a relatively common complication in anterior cervical decompression and fusion. This study investigated the effect of preoperative ST intervention on prevention of dysphagia following cervical anterior decompression fusion surgery and risk factors for the occurrence of postoperative dysphagia, including preoperative swallowing function.

Methods: A total of 116 patients who underwent anterior cervical decompression and fusion after preoperative ST evaluation of swallowing function (tongue pressure and repetitive saliva swallowing test [RSST]) on the day before surgery were included. Patients were divided into postoperative dysphagia (+) and (−) groups, and radiological parameters and preoperative swallowing function on the day before surgery were compared. The effectiveness of preoperative swallowing training was also evaluated in 60 patients who underwent ST evaluation at the time of admission for myelography.

Results: Postoperative dysphagia occurred in 12.9% (15/116). The dysphagia (+) group had higher age, higher level of fixation, and lower preoperative tongue pressure and RSST compared to the dysphagia (−) group. Postoperative C2-7 and ΔC2-7 angles, corresponding to pre- and postoperative change, respectively, were significantly higher in the dysphagia (+) group. Regarding ST intervention at the time of admission for myelography, tongue pressure improved significantly, but there was no significant difference in RSST.

Conclusions: The results of this study indicate that preoperative swallowing function is related to the occurrence of dysphagia after anterior cervical decompression and fusion. The results also suggest that swallowing training by ST improves swallowing function at the time of surgery.