title: A Meta-Analysis of the Incidence of Patient-Reported Dysphagia After Anterior Cervical Decompression and Fusion with the Zero-Profile Implant System.
abstract: Dysphagia is a well-known complication following anterior cervical surgery. It has been reported that the Zero-profile Implant System can decrease the incidence of dysphagia following surgery, however, dysphagia after anterior cervical decompression and fusion (ACDF) with the Zero-profile Implant System remains controversial. Previous studies only focus on small sample sizes. The objective of this study was to determine the incidence of dysphagia after ACDF with the Zero-profile Implant System. Studies were collected from PubMed, EMBASE, the Cochrane library and the China Knowledge Resource Integrated Database using the keywords "Zero-profile OR Zero-p) AND (dysphagia OR [swallowing dysfunction]". The software STATA (Version 13.0) was used for statistical analysis. Statistical heterogeneity across the various trials, a test of publication bias and sensitivity analysis was performed. 30 studies with a total of 1062 patients were included in this meta-analysis. The occurrence of post-operative transient dysphagia ranged from 0 to 76 % whilst the pooled incidence was 15.6 % (95 % CI, 12.6, 18.5 %). 23 studies reported no persistent dysphagia whilst seven studies reported persistent dysphagia ranging from 1 to 7 %). In summary, the present study observed a low incidence of both transient and persistent dysphagia after ACDF using the Zero-profile Implant System. Most of the dysphagia was mild and gradually decreased during the following months. Moderate or severe dysphagia was uncommon. Future randomized controlled multi-center studies and those focusing on the mechanisms of dysphagia and methods to reduce its incidence are required.
authors.affiliation: Department of orthopedics, West China Hospital, Sichuan University, No. 37, GuoXueXiang, Chengdu, 610041, Sichuan Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of orthopedics, West China Hospital, Sichuan University, No. 37, GuoXueXiang, Chengdu, 610041, Sichuan Province, China.
authors.forename: Litai
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of orthopedics, West China Hospital, Sichuan University, No. 37, GuoXueXiang, Chengdu, 610041, Sichuan Province, China. liuhao6304@hotmail.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: MangMang
authors.initials: M
authors.lastname: Xu
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000295:instrumentation; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications; D019736:Prostheses and Implants; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome
keywords: ACDF; Dysphagia; Meta-analysis; Zero-P; Zero-profile