Affordable Access

deepdyve-link
Publisher Website

Critical analysis of the evaluation of postoperative dysphagia following an anterior cervical discectomy and fusion.

Authors
  • Kaufman, Matthew1
  • Shearer, Jennifer2
  • Cabrera, Claudia I3
  • Terry, Morgan2
  • Jackson, Elizabeth2
  • Kominsky, Rachel4
  • Njoku, Innocent5
  • Otteson, Todd3
  • Furey, Christopher6
  • Howard, N Scott3
  • 1 Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States of America. Electronic address: [email protected] , (United States)
  • 2 Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States of America. , (United States)
  • 3 Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States of America; University Hospitals Ear, Nose, and Throat Institute, University Hospitals, Cleveland, OH 44106, United States of America. , (United States)
  • 4 University Hospitals Ear, Nose, and Throat Institute, University Hospitals, Cleveland, OH 44106, United States of America. , (United States)
  • 5 University Hospitals Spine Center, UH Cleveland Medical Center, Cleveland, OH 44106, United States of America. , (United States)
  • 6 Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States of America; University Hospitals Spine Center, UH Cleveland Medical Center, Cleveland, OH 44106, United States of America. , (United States)
Type
Published Article
Journal
American journal of otolaryngology
Publication Date
Apr 10, 2022
Volume
43
Issue
3
Pages
103466–103466
Identifiers
DOI: 10.1016/j.amjoto.2022.103466
PMID: 35427936
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Postoperative dysphagia is a known complication of anterior cervical discectomy and fusion (ACDF) with reported incidences ranging from 1 to 79%. No standardized guidelines exist for spine surgeons to evaluate postoperative dysphagia after ACDF. A systematic method may be beneficial in distinguishing transient postoperative dysphagia secondary to intubation from those with postoperative complications. This study evaluates the causes, recognition, and clinical evaluation of postoperative dysphagia following ACDF. International classification of disease (ICD) and current procedural terminology (CPT) codes were used to identify ACDF patients and compared to anterior lumbar discectomy and fusion (ALDF), serving as a control group, between the years 2015-2019 and those diagnosed with dysphagia within 1 year. Demographics, operative details, and clinical evaluation were reviewed. Exclusion criteria included history of head and neck procedures, cancer, stroke, radiation, and trauma. One hundred thirty-one ACDF and 93 ALDF patients met inclusion criteria. Twenty-seven (20.6%) ACDF patients were diagnosed with dysphagia within 1 year. Less than half of the dysphagia patients had the word "dysphagia" documented in their 1-month spine surgeon follow up visit. Only 66% of dysphagia patients had specialist evaluation and one third of those patients were referred by their surgeon. Only six patients received diagnostic barium swallow evaluations. Postoperative dysphagia risk increases in ACDF compared to ALDF, likely due to underlying anatomy. Postoperative dysphagia symptoms are not effectively documented by spine surgeons and as a result underevaluated by dysphagia specialists. Patients may benefit from more extensive pre- and post-operative screening, evaluation, and referral regarding dysphagia symptoms following ACDF. Copyright © 2022 Elsevier Inc. All rights reserved.

Report this publication

Statistics

Seen <100 times