A cohort study of the morbidity of combined anterior-posterior cervical spinal fusions: incidence and predictors of postoperative dysphagia
Kevin A. Reinard, Diana M. Cook, Hesham M. Zakaria, Azam M. Basheer, Victor W. Chang, Muwaffak M. Abdulhak
June 2016, Volume 25, Issue 7, pp 2068 - 2077 Original Article Read Full Article 10.1007/s00586-016-4429-0
First Online: 14 March 2016
To identify risk factors that may lead to the development of dysphagia after combined anterior and posterior (360°) cervical fusion surgery.
A single center, retrospective analysis of patients who had same-day, 360° fusion at Henry Ford Hospital between 2008 and 2012 was performed. Variables analyzed included demographics, medical co-morbidities, levels fused, and degree of dysphagia.
The overall dysphagia rate was 37.7 %. Patients with dysphagia had a longer mean length of stay (p < 0.001), longer mean operative time (p < 0.001), greater intraoperative blood loss (p = 0.002), and fusion above the fourth cervical vertebra, C4, (p = 0.007). There were no differences in the rates of dysphagia when comparing patients undergoing primary or revision surgery (p = 0.554).
Prolonged surgery and fusion above C4 lead to higher rates of dysphagia after 360° fusions. Prior anterior cervical fusion does not increase the risk of dysphagia development.
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