title: Long-term result of vocal cord paralysis after anterior cervical disectomy.
abstract: OBJECTIVE
  Anterior cervical disectomy and fusion (ACDF) is a highly effective and safe method for spinal cord and cervical root decompression. However, vocal cord paralysis (VCP) remains an important cause of postoperative morbidity. The true incidence and recovery course of postoperative VCP is still uncertain. This study is a report on VCP after ACDF to evaluate the incidence, recovery course, and possible risk factors.
  
  
  METHODS
  From 2004 to 2008, 1,895 consecutive patients underwent ACDF in our hospital and were followed up for at least 3 years. All surgeons were well trained and used a right-sided exposure. Prolonged VCP, where patients suffered from postoperative VCP lasting more than 3 months, was recorded and analyzed.
  
  
  RESULTS
  In this retrospective study, 9 of the 1,895 patients (0.47%) documented prolonged VCP lasting over 3 months. Six of the nine patients had total recovery within 9 months. Only three patients (0.16%) still had symptoms even after 3 years postoperatively. All symptoms of VCP, except hoarseness, could be improved. After matching with 36 non-VCP patients, no differences with regard to longer operative or anesthesia time, shorter neck, obesity, and prevertebral edema. All cases of prolonged course of postoperative VCP occurred in patients who underwent exposure at the C67 level.
  
  
  CONCLUSIONS
  In our study, only 0.47% documented prolonged postoperative VCP, while most patients recovered within 9 months. However, if symptoms last longer, there could be almost permanent VCP (0.16%). In our study, choking and dysphagia subsided mostly within 6 months, but hoarseness remained. The exposure of the C67 level obviously was a risk factor for postoperative VCP.
authors.affiliation: Department of Neurosurgery, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, No 5, Fu-Shin Street, Kwei-Shan, Tao-Yuan County, Linkou, 333, Taiwan.
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Chen
authors.forename: Yin-Cheng
authors.initials: YC
authors.lastname: Huang
authors.forename: Shih-Tseng
authors.initials: ST
authors.lastname: Lee
authors.forename: Jyi-Feng
authors.initials: JF
authors.lastname: Chen
authors.forename: Chieh-Tsai
authors.initials: CT
authors.lastname: Wu
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Tu
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology*