A new study found that prior thyroidectomy and the number of spinal levels addressed during anterior cervical discectomy and fusion are risk factors for postoperative otolaryngologic complications including dysphagia.
The study, “Primary and Revision Anterior Cervical Discectomy and Fusion, A Study of Otolaryngologic Outcomes in a Large Cohort,” was published in the January 2022 issue of Spine journal.
“Swallowing and voice dysfunction are frequent postoperative complaints after anterior cervical discectomy and fusion surgery with a published incidence varying between 1.2% and 60%. A thorough understanding of the incidence and risk factors for these complications is needed,” the researchers wrote.
For the study, they examined the electronic medical records of adults who underwent anterior cervical discectomy with predicted difficult surgical site exposure performed by two-surgeon approach between 2008 and 2018.
The patients were categorized by primary or revision anterior cervical discectomy and by the number of levels addressed during the procedure.
Overall, 718 patients were included in the study. Their average age was 55.8 years and 45% of them were women. About 27% of the patients underwent revision anterior cervical discectomy and fusion.
For 74 patients whether it was a primary or revision procedure was not able to be determined. Seventy-nine cases involved one spinal level.
Overall new postoperative otolaryngologic symptoms among those who underwent primary and revision anterior cervical discectomy and fusion were 12.6% and 10.9%, respectively.
“No evidence was found of an association between postoperative otolaryngologic symptoms and revision anterior cervical discectomy and fusion (OR, 0.84 [95% CI, 0.48-1.49]; p = 0.55), but evidence was found of an association with prior thyroidectomy (aOR, 3.8 [95% CI, 1.53-8.94], p = 0.0003).”
“Evidence was also found of increased odds for new postoperative dysphagia with increasing number of surgical levels (aOR, 1.5 [95% CI, 1.09-2.07]; p = 0.01).”
“Prior thyroidectomy and number of spinal levels addressed during anterior cervical discectomy and fusion were identified as risk factors for postoperative otolaryngologic complications including dysphagia. Revision anterior cervical discectomy and fusion was not associated with increased odds of postoperative otolaryngologic symptoms or dysphagia,” the researchers wrote.
Study authors include Michele Wong, B.A. of SUNY Downstate Health Sciences University, and Nicholas Williams, M.P.H. and Ashutosh Kacker, M.B.B.S., M.D. of Weill Cornell Medicine.
