Incidence and risk factor analysis of dysphagia after anterior cervical corpectomy and fusion: evidence from 297 patients

A large number of previous studies have explored the clinical and radiological outcomes of anterior cervical corpectomy and fusion (ACCF); however, dysphagia after ACCF has been ignored in previous studies and the incidence, severity, and duration of dysphagia after ACCF remains unknown at present. A total of 297 patients who underwent ACCF were included in this study, dysphagia was evaluated according to the Bazaz grading system before surgery and at each follow-up. An unpairedt-test and the Mann-Whitney U-test were used to compare the parameters of patients in both dysphagia, and non-dysphagia, groups. Ordinal logistic regression was performed to determine the risk factors of dysphagia. The incidence of dysphagia was 25.253% at one week, 20.202% at one month, 16.162% at three months, 11.111% at six months, 8.418% at 12 months, and 6.734% at the final follow-up. Results from ordinal logistic regression showed that female patients (95% CI [1.098, 2.813], P=0.013), long operation time (95% CI [1.075, 8.036], P=0.012) were associated with higher incidence of dysphagia. However, blood loss, involvement of C4-5 surgery, involvement of C5-6 surgery, kind of cages, kind of plates, and different surgeons were not found to be associated with higher incidence of dysphagia in this study. Most of the dysphagia after ACCF was mild and gradually decreased during the following months. Moderate or severe dysphagia was uncommon. Female patients and a long operation time may be associated with higher incidence of dysphagia. Future studies are needed to validate these findings.