title: Incidence of Dysphagia and Serial Videofluoroscopic Swallow Study Findings After Anterior Cervical Discectomy and Fusion: A Prospective Study.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  To prospectively assess the incidence of dysphagia and to present the serial changes of each finding in the videofluoroscopic swallow study (VFSS) after anterior cervical discectomy and fusion (ACDF).
  
  
  BACKGROUND
  The reported incidence of dysphagia after ACDF has varied widely, and the serial changes of dysphagia using VFSS have not been clearly determined yet.
  
  
  METHODS
  Data of 47 patients preoperatively and at 1 week and 1 month postoperatively were used for the analyses. The Bazaz dysphagia score and VFSS were checked preoperatively and at 1 week and 1 month postoperatively. The presence of aspiration or penetration, amount of vallecular and pyriform sinus residues, functional dysphagia scale, temporal parameters of oral transit time, pharyngeal transit time, and pharyngeal delay time (PDT) were evaluated from the VFSS data.
  
  
  RESULTS
  Incidences of dysphagia measured by the Bazaz dysphagia score were 83.0% at 1 week and 59.6% at 1 month after ACDF. Although the incidence of aspiration was 4.3% and the incidence of penetration was 36.2% at 1 week and 25.5% at 1 month after surgery, none of the patients had aspiration pneumonia. The number of patients with vallecular and pyriform sinus residues significantly increased after ACDF. Further, there were no statistically significant changes at all time points in terms of oral transit time, pharyngeal transit time, and pharyngeal delay time.
  
  
  CONCLUSIONS
  Dysphagia is common until 1 month after ACDF. Although the incidence of aspiration or penetration in VFSS after ACDF was high, no patient had aspiration pneumonia, which may be because of the intact neurological swallowing mechanism. The typical pattern of dysphagia after ACDF included vallecular and pyriform sinuses filled with postswallow residue, which may result from soft tissue edema and weak constriction of pharyngeal muscles after ACDF.
authors: *Department of Rehabilitation Medicine†Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Yusun
authors: Y
authors: Min
authors: Won-Seok
authors: WS
authors: Kim
authors: Sung Shik
authors: SS
authors: Kang
authors: Jin Man
authors: JM
authors: Choi
authors: Jin S
authors: JS
authors: Yeom
authors: Nam-Jong
authors: NJ
authors: Paik
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery*; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects*; D005471:Fluoroscopy; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D011843:Radiculopathy / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D014741:Video Recording