title: Dysphagia after anterior cervical spine surgery: incidence and risk factors.
abstract: OBJECTIVE
  To evaluate risk factors for the development of dysphagia after anterior cervical surgery.
  
  
  METHODS
  The records of 249 patients who underwent anterior cervical surgery were reviewed. The presence and severity of dysphagia were assessed with the Dysphagia Disability Index 6 weeks and 3, 6, and 12 months after surgery. Age; sex; ethnicity; cigarette smoking; previous cervical surgeries; reoperation for same pathology; type of procedure, incision, and instrumentation; number and levels involved; side of procedure, length of surgery; and use of postoperative bracing were analyzed.
  
  
  RESULTS
  During the first 6 months after surgery, 27 (10.8%) patients developed dysphagia. From these patients the presence of dysphagia at 6 weeks and at 3 and 6 months was 88.8%, 29.6%, and 7.4%, respectively. By 12 months, dysphagia had resolved in all cases. The mean age of patients with dysphagia was 55 years (SD 12.98) and 50 years (SD 12.07) in patients without dysphagia (P = 0.05). Dysphagic patients had an average of 2.2 (SD 1.15) levels operated compared with 1.84 (SD 0.950) in nondysphagic patients (P = 0.05). Patients who developed dysphagia were most often treated at C4-5 (67%) and C5-6 (81%: P < 0.001). Although mean operative time was slightly longer in patients with dysphagia (186 minutes) compared with those without (169 minutes), the difference was not significant.
  
  
  CONCLUSIONS
  In our patients, the incidence of dysphagia was low, and it had completely resolved at 12 months in all cases. Risk factors for dysphagia were multilevel procedures, involvement of C4-5 and C5-6, and age.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kalb
authors.forename: Marco T
authors.initials: MT
authors.lastname: Reis
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Cowperthwaite
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Fox
authors.forename: Richard
authors.initials: R
authors.lastname: Lefevre
authors.forename: Nicholas
authors.initials: N
authors.lastname: Theodore
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Papadopoulos
authors.forename: Volker K H
authors.initials: VK
authors.lastname: Sonntag
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001860:Bone Plates; D001915:Braces; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000209:etiology*; D004185:Disability Evaluation; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D012086:Reoperation; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013131:Spine / Q000601:surgery*; D011795:Surveys and Questionnaires