title: Dysphagia after anterior cervical spine surgery: a prospective study using the swallowing-quality of life questionnaire and analysis of patient comorbidities.
abstract: METHODS
  Prospective study of 29 patients who underwent anterior cervical (AC) or posterior lumbar (PL) spinal surgery. A validated measure of dysphagia, the Swallowing-Quality of Life (SWAL-QOL) survey, was used to assess the degree of postoperative dysphagia.
  
  
  OBJECTIVE
  To determine the degree of dysphagia preoperatively and postoperatively in patients undergoing AC surgery compared with a control group that underwent PL surgery.
  
  
  BACKGROUND
  Dysphagia is a well-known complication of AC spine surgery and has been shown to persist for up to 24 months or longer.
  
  
  METHODS
  A total of 18 AC patients and a control group of 11 PL patients were prospectively enrolled in this study and were assessed preoperatively and at 3 weeks and 1.5 years postoperatively using a 14-item questionnaire from the SWAL-QOL survey to determine degree of dysphagia. Other patient factors and anesthesia records were examined to evaluate their relationship to dysphagia.
  
  
  RESULTS
  There were no significant differences between the AC and PL groups with respect to age, sex, body mass index, or length of surgery. The SWAL-QOL scores at 3 weeks were significantly lower for the AC group than for the PL group (76 vs. 96; P = 0.001), but there were no differences between the groups preoperatively or at final follow-up. Smokers, patients with chronic obstructive pulmonary disease, and women had lower SWAL-QOL scores at one or more time point.
  
  
  CONCLUSIONS
  Patients undergoing AC surgery had a significant increase in the degree of dysphagia 3 weeks after surgery compared with patients undergoing PL surgery. By final follow-up, swallowing in the AC group recovered to a level similar to preoperative and comparable to that in patients undergoing lumbar surgery at 1.5 years. Smoking, chronic obstructive pulmonary disease, and female sex are possible factors in the development of postoperative dysphagia.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Siska
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Ponnappan
authors.forename: Justin B
authors.initials: JB
authors.lastname: Hohl
authors.forename: Joon Y
authors.initials: JY
authors.lastname: Lee
authors.forename: James D
authors.initials: JD
authors.lastname: Kang
authors.forename: William F
authors.initials: WF
authors.lastname: Donaldson
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D017586:Diskectomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards