title: Incidence of dysphagia comparing cervical arthroplasty and ACDF.
abstract: METHODS
  Retrospective cohort from randomized prospective clinical trial.
  
  
  OBJECTIVE
  Evaluate incidence of dysphagia between instrumented ACDF and a no-profile cervical disc arthroplasty.
  
  
  BACKGROUND
  Dysphagia is a well-known complication following anterior cervical discectomy and fusion (ACDF) and the etiology is multifactorial. One potential source for postoperative dysphagia involves the anterior profile of the implant used. Hence, a no-profile cervical disc arthroplasty could theoretically have fewer soft tissue adhesions and a lower incidence of dysphagia. The purpose of this study is to compare the incidence of dysphagia at least 1 year postoperatively following ACDF with anterior plating and a no-profile cervical disc arthroplasty.
  
  
  METHODS
  A cohort of 87 patients meeting the inclusion criteria for the prospective, randomized, multicenter IDE trial of ProDisc-C versus ACDF were evaluated for dysphagia. Forty-five patients were randomized to receive cervical arthroplasty and 42 patients were randomized to the ACDF and plate group. The Bazaz-Yoo dysphagia questionnaire was administered in a blinded fashion after completion of at least 12 months follow-up.
  
  
  RESULTS
  Follow-up averaged 18.2 months and included 76 (87%) of the 87 enrolled, with 38 of the original 45 in the arthroplasty group and 38 of the original 42 in the ACDF group. Six of 38 (15.8%) in the arthroplasty group versus 16 of 38 (42.1%) in the ACDF group reported ongoing dysphagia complaints. This was found to be statistically significant (P = .03).
  
  
  CONCLUSIONS
  This study suggests a significantly lower rate of dysphagia with a no-profile cervical disc arthroplasty compared to instrumented ACDF for single level disc disease between C3-7. Though there are many potential etiologies, we hypothesize this is related to the lack of anterior hardware in the retropharyngeal space. Operative technique, operating time, and significant midline retraction did not seem to result in more dysphagia complaints. Future studies comparing cervical disc arthroplasty and no-profile fusion devices may help delineate the effect that anterior instrumentation profile has on postoperative dysphagia.
authors: OrthoCarolina Spine Center, Charlotte, NC.
authors: Brad
authors: B
authors: Segebarth
authors: Soronan Spine Center, Mesa, AZ.
authors: Jason C
authors: JC
authors: Datta
authors: OrthoCarolina Spine Center, Charlotte, NC.
authors: Bruce
authors: B
authors: Darden
authors: Spine Education and Research Institute, Denver, CO.
authors: Michael E
authors: ME
authors: Janssen
authors: OrthoCarolina Spine Center, Charlotte, NC.
authors: Daniel B
authors: DB
authors: Murrey
authors: OrthoCarolina Spine Center, Charlotte, NC.
authors: Alfred
authors: A
authors: Rhyne
authors: Spine Education and Research Institute, Denver, CO.
authors: Ruth
authors: R
authors: Beckham
authors: Spine Education and Research Institute, Denver, CO.
authors: Caroline
authors: C
authors: Ponce
keywords: Anterior cervical discectomy; Cervical disc arthroplasty; Dysphagia; Prodisc-C