(0833) Risk Factors for Dysphagia Development After Anterior Cervical Spine Surgery

Introduction: The incidence of dysphagia after anterior cervical discectomy and fusion (ACDF) is widely disputed, however, this complication has detrimental effects on patients' quality of life. The purpose of this study is to identify potential risk factors for the development of dysphagia in patients undergoing ACDF.

Methods: A retrospective cohort study at a single institution was performed between January 1, 2022 and January 1, 2023 using the Epic Slicer-Dicer function. All patients who underwent primary ACDF were included in initial evaluation. Patients were excluded if they were under 18 years old, incarcerated, pregnant, had previous neck surgery, or had pre operative dysphagia or dysphonia. Variables of interest included patient age, sex, body mass index (BMI), past medical history, involved vertebrae, post operative dysphonia, and postoperative dysphagia. Statistical analysis was performed using ANOVA and student’s T-test.

Results: In the one-year study period 124 patients met inclusion criteria. The cohort was 58% female with an average age of 53.5 +/- 10.3 years. There were no significant differences in incidence of post operative dysphagia based on age, sex, or BMI in our cohort. A history of rheumatologic disease or musculoskeletal disease were more likely to have post operative dysphagia (p = 0.01, p = 0.01). Patients with a greater number of involved cervical vertebrae were more likely to experience post operative dysphagia (2.13 vs 1.6, p = 0.002). Patients who experienced post operative dysphagia were more likely to also report postoperative dysphonia (p = 0.05).

Conclusions: The data presented here support the published the literature regarding dysphagia after ACDF. Patients with a history of rheumatologic or musculoskeletal disease and patients with more involved vertebrae are at increased risk for postoperative dysphagia. Enhanced knowledge regarding risk factors for postoperative dysphagia will allow physicians to better counsel and consent patients prior to surgery. Additionally, those patients who are have many risk factors may benefit from preoperative swallow therapy.