title: Incidence of dysphagia after anterior cervical spine surgery: a prospective study.
abstract: METHODS
  A prospective longitudinal study was conducted to evaluate dysphagia after anterior cervical spine surgery.
  
  
  OBJECTIVE
  To evaluate the incidence and natural history of dysphagia after anterior cervical spine surgery, and to identify risk factors for the development of postoperative dysphagia.
  
  
  BACKGROUND
  The literature contains only retrospective evaluations of postoperative dysphagia. A wide range of incidence has been reported in these studies.
  
  
  METHODS
  Altogether, 249 consecutive patients undergoing anterior cervical spine surgery were eligible for the study. These patients were contacted 1, 2, 6, and 12 months after the procedure to evaluate swallowing. Risk factors such as age, gender, procedure type, hardware use, and number and location of surgical levels addressed were assessed.
  
  
  RESULTS
  Dysphagia incidences of 50.2%, 32.2%, 17.8%, and 12.5% were found at 1, 2, 6, and 12 months, respectively. At 6 months after the procedure, only 4.8% of the patients were experiencing moderate or severe dysphagia. Patient age, type of procedure (corpectomy vs. discectomy or primary vs. revision), hardware presence, and location of surgical levels were not statistically significant risk factors for the development of postoperative dysphagia. Female gender was significant for increased risk of dysphagia at 6 months. Surgery at multiple disc levels increased the risk of postoperative dysphagia at 1 and 2 months. The etiology of the dysphagia in most of the patients was unknown. However, vocal cord paresis was identified in 1.3% of the patients at 12 months.
  
  
  CONCLUSIONS
  Dysphagia after anterior cervical spine surgery is a common early finding. However, it decreases significantly by 6 months. The minority of patients experience moderate or severe symptoms by 6 months after the procedure. Female gender and multiple surgical levels could be identified as risk factors for the development of postoperative dysphagia.
authors.affiliation: Spine Institute and Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio 44106, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Bazaz
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lee
authors.forename: Jung U
authors.initials: JU
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology*; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009333:Neck; D011184:Postoperative Period; D011446:Prospective Studies; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects*; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology