title: Comparison of the incidence of patient-reported post-operative dysphagia between ACDF with a traditional anterior plate and artificial cervical disc replacement.
abstract: OBJECTIVE
  Compared with anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR) has provided satisfactory clinical results. The incidence of post-operative dysphagia between ACDF with a traditional anterior plate and CDR remains controversial. Considering the limited studies and knowledge in this area, a retrospective study focusing on post-operative dysphagia was conducted.
  
  
  METHODS
  The Bazaz grading system was used to assess the severity of dysphagia at post-operative intervals including 1 week, 1 month, 3 months, 6 months, 12 months and 24 months respectively. The Chi-square test, Student t-test, Mann-Whitney U tests and Ordinal Logistic regression were used for data analysis when appropriate. Statistical significance was accepted at a probability value of <0.05.
  
  
  RESULTS
  Two hundred and thirty-one patients in the CDR group and one hundred and fifty-eight patients in Plate group were included in this study. The total incidences of dysphagia in the CDR and plate group were 36.58% and 60.43% at one week, 29.27% and 38.85% at one month, 21.95% and 31.65% at three months, 6.83% and 17.99% at six months, 5.85% and 14.39% at 12 months, and 4.39% and 10.07% at the final follow-up respectively (All P<0.05, Mann-Whitney U test). Ordinal Logistic regression analysis showed that female patients, two-level surgery, C4/5 surgery, and anterior cervical plating were significant risk factors for post-operative dysphagia (all P<0.05).
  
  
  CONCLUSIONS
  Comparing ACDF with a plate, CDR with a Prestige LP can significantly reduce both transient and persistent post-operative dysphagia. Female patients, two-level surgery, C4/5 surgery and anterior cervical plating were associated with a higher incidence of dysphagia. Future prospective, randomized, controlled studies are needed to further validate these findings.
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: hxyy@live.cn.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: ma.litai@163.com.
authors.forename: Litai
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: liuhao6304@hotmail.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Ecology and Evolutionary Biology, University of California, Los Angeles, USA. Electronic address: ellenliu12@g.ucla.edu.
authors.forename: Yilian
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Operation Room, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: hongying518@hotmail.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: dove-baker@126.com.
authors.forename: Beiyu
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: dclxm_84213@163.com.
authors.forename: Chen
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: nanshine710@gmail.com.
authors.forename: Yuxiao
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: yueming_song@163.com.
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: 18980601394@163.com.
authors.forename: Limin
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D017586:Diskectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D059145:Total Disc Replacement / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
keywords: ACDF; Cervical disc replacement; Deglutition; Deglutition disorders; Dysphagia; Plate; Prestige LP