Dysphagia after anterior cervical spine surgery: incidence and risk factors

World Neurosurg. 2012 Jan;77(1):183-7. doi: 10.1016/j.wneu.2011.07.004. Epub 2011 Nov 15.


Objective: To evaluate risk factors for the development of dysphagia after anterior cervical surgery.

Methods: The records of 249 patients who underwent anterior cervical surgery were reviewed. The presence and severity of dysphagia were assessed with the Dysphagia Disability Index 6 weeks and 3, 6, and 12 months after surgery. Age; sex; ethnicity; cigarette smoking; previous cervical surgeries; reoperation for same pathology; type of procedure, incision, and instrumentation; number and levels involved; side of procedure, length of surgery; and use of postoperative bracing were analyzed.

Results: During the first 6 months after surgery, 27 (10.8%) patients developed dysphagia. From these patients the presence of dysphagia at 6 weeks and at 3 and 6 months was 88.8%, 29.6%, and 7.4%, respectively. By 12 months, dysphagia had resolved in all cases. The mean age of patients with dysphagia was 55 years (SD 12.98) and 50 years (SD 12.07) in patients without dysphagia (P = 0.05). Dysphagic patients had an average of 2.2 (SD 1.15) levels operated compared with 1.84 (SD 0.950) in nondysphagic patients (P = 0.05). Patients who developed dysphagia were most often treated at C4-5 (67%) and C5-6 (81%: P < 0.001). Although mean operative time was slightly longer in patients with dysphagia (186 minutes) compared with those without (169 minutes), the difference was not significant.

Conclusions: In our patients, the incidence of dysphagia was low, and it had completely resolved at 12 months in all cases. Risk factors for dysphagia were multilevel procedures, involvement of C4-5 and C5-6, and age.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Bone Plates
  • Braces
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / adverse effects
  • Deglutition Disorders / epidemiology*
  • Deglutition Disorders / etiology*
  • Disability Evaluation
  • Ethnicity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Reoperation
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Spine / surgery*
  • Surveys and Questionnaires