title: Risk Factors for Dysphagia After Single-Level Anterior Cervical Decompression with Arthroplasty or Fusion: A Prospective Study Comparing 2 Zero-Profile Implants.
abstract: OBJECTIVE
  To determine any differences in self-reported dysphagia in patients treated with single-level anterior cervical decompression with different zero-profile implants (arthroplasty vs. arthrodesis) and identify risk factors for postoperative dysphagia.
  
  
  METHODS
  A total of 112 patients with 1-level cervical degenerative disc disease were included in the prospective study. The dysphagia conditions and radiologic results were assessed using Bazar dysphagia scoring system, the Swallowing Quality of Life scores, cervical alignment (CA), segmental angle, and prevertebral soft tissues swelling (PSTS). All these parameters were compared before and after surgery in the respective group, which were also compared between the 2 groups. Correlations between the confounding factors and postoperative dysphagia were analyzed.
  
  
  RESULTS
  No significant differences existed in preoperative or initially postoperative dysphagia rate and scores between the 2 groups (P > 0.05). However, the dysphagia rate and scores of cervical disc arthroplasty was better than those of fusion at postoperative day 7. Heavy smoker, PSTS change (≥5 mm), or CA change (≥5 degrees) was prone to have postoperative dysphagia.
  
  
  CONCLUSIONS
  Postoperative dysphagia remains a common incidence, despite advances in instrumentation technologies. However, cervical disc arthroplasty is superior to anterior cervical discectomy and fusion in ameliorating the symptom of dysphagia in the early postoperative term. Heavy smoker, PSTS change (≥5 mm), and CA change (≥5 degrees) were important predictors of postoperative dysphagia.
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors: Sheng
authors: S
authors: Shi
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors: Xin-Feng
authors: XF
authors: Li
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors: Qi-Tong
authors: QT
authors: Zhao
authors: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
authors: Li-Li
authors: LL
authors: Yang
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China. Electronic address: rjliuzd@163.com.
authors: Zu-De
authors: ZD
authors: Liu
authors: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China. Electronic address: spinewenyuan@126.com.
authors: Wen
authors: W
authors: Yuan
mesh_terms: D000328:Adult; D001178:Arthroplasty; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D003680:Deglutition Disorders / Q000453:epidemiology*; D017586:Diskectomy; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D019736:Prostheses and Implants; D012307:Risk Factors; D013123:Spinal Fusion; D059145:Total Disc Replacement
keywords: Anterior cervical discectomy and fusion; Cervical alignment; Cervical disc arthroplasty; Dysphagia; Prevertebral soft tissue swelling; Zero-profile