Comparison of Patient-Reported Postoperative Dysphagia in Patients Undergoing One-Level Versus Two-Level Anterior Cervical Discectomy and Fusion with the Zero-P Implant System
- 2 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Dysphagia
- Vol. 36 (4), 743-753
- https://doi.org/10.1007/s00455-020-10197-w
Abstract
To investigate whether dysphagia differs between one-level and two-level anterior cervical discectomy and fusion (ACDF) with the Zero Profile (Zero-P) Implant System. A retrospective analysis of 208 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up was performed from January 2013 to December 2018. The patients were divided into two groups based on the number of operated levels (one-level group, N = 86; two-level group, N = 122). Dysphagia was assessed based on the Bazaz grading system. The incidence of dysphagia and the severity of dysphagia at each follow-up were compared between the two groups. The patients were divided into two groups (nondysphagia group, N = 160; dysphagia group, N = 48), and covariates were obtained for multivariate analysis, including demographic parameters, surgical parameters, and radiographic parameters. The results showed that the incidence and severity of postoperative dysphagia in the two-level group were significantly greater at 1 week, 1 month and 3 months postoperatively than those in the one-level group. The results of ordinal logistic regression showed that older age, two-level surgery, greater prevertebral soft tissue swelling (PSTS) and the difference between the postoperative and preoperative C2–7 angle (dC2–7A) were significantly associated with a higher incidence of dysphagia after ACDF with the Zero-P. Two-level ACDF with the Zero-P can result in a significantly greater incidence and severity of transient postoperative dysphagia. Older age, greater PSTS and the dC2-7A were also associated with postoperative dysphagia after ACDF with the Zero-P.Keywords
Funding Information
- Department of Science and Technology of Sichuan Province (2020YFS0075)
- Sichuan Province Science and Technology Support Program (2019YFQ0002)
- West China Hospital, Sichuan University (HX-H1812210, No. 2019HXFH040)
- West China Hospital, Sichuan University (HX-H1812210, No. 2019HXFH040)
This publication has 48 references indexed in Scilit:
- The O-C2 angle established at occipito-cervical fusion dictates the patient’s destiny in terms of postoperative dyspnea and/or dysphagiaEuropean Spine Journal, 2013
- Dysphagia After Anterior Cervical Spine Surgery: Incidence and Risk FactorsWorld Neurosurgery, 2012
- Dysphagia After Anterior Cervical Spine SurgerySpine, 2011
- A New Zero-profile Implant for Stand-alone Anterior Cervical Interbody FusionClinical Orthopaedics and Related Research, 2011
- The Efficacy of Plate Construct Augmentation Versus Cage Alone in Anterior Cervical FusionSpine, 2009
- Upper-Airway Obstruction After Short Posterior Occipitocervical Fusion in a Flexed PositionSpine, 2007
- Intraoperative measurement of pharynx/esophagus retraction during anterior cervical surgery. Part II: perfusionEuropean Spine Journal, 2006
- Intraoperative measurement of pharynx/esophagus retraction during anterior cervical surgery. Part I: pressureEuropean Spine Journal, 2006
- Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up studyEuropean Spine Journal, 2005
- Anterior Cervical Plating Enhances Arthrodesis after Discectomy and Fusion with Cortical AllograftNeurosurgery, 2002