(0826) Outcomes of Open Osteophytectomy in Pharyngeal Dysphagia Related to Cervical Osteophytes: A Systematic Review

Introduction: Our study investigates the efficacy of osteophytectomy in patients with dysphagia associated with cervical osteophytes.

Methods: We conducted a systematic review of the published literature pertaining to osteophyte-related dysphagia. Patients with objective measurements of dysphagia severity who underwent an open surgical approach for osteophytectomy were included. Demographics, symptomatology, and patient outcomes were analyzed.

Results: A total of 42 articles with 212 cases (mean age 67, 84% male) were included. Cases were split into 3 groups based on level of vertebral involvement: diffuse, above C4, and C4 and below. Dysphagia was experienced by 100% of patients; the most prominent other symptoms were neck pain (16%), dysphonia (14%), and dyspnea (13%). The above C4 group had a statistically higher incidence of reduced neck ROM and globus sensation compared to the diffuse group (21% vs 5%, p = 0.026; 18% vs 1% p = 0.006). Short-term outcomes ( < 6 weeks) and long-term outcomes (> 6 weeks) among the 3 groups were not statistically different. Among all cases, 84% of patients experienced significant short-term initial improvement in their dysphagia. Beyond 6 weeks, 73% of patients had continued significant improvement in their dysphagia outcome.

Conclusions: Open surgical approaches for osteophytectomy demonstrate good short-term efficacy, with 84% of patients experiencing an initial significant improvement in dysphagia. However, long term efficacy is modest, with 73% of patients continuing to report a significant improvement in dysphagia beyond 6 weeks of follow up, demonstrating a need for counseling prior to osteophytectomy.