PMID- 37830799
OWN - NLM
STAT- MEDLINE
DCOM- 20240216
LR  - 20240216
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 94
IP  - 3
DP  - 2024 Mar 1
TI  - Early Voice and Swallowing Disturbance Incidence and Risk Factors After Revision 
      Anterior Cervical Discectomy and Fusion Using a Multidisciplinary Surgical 
      Approach: A Retrospective Cohort Evaluation of a Prospective Database.
PG  - 444-453
LID - 10.1227/neu.0000000000002704 [doi]
AB  - BACKGROUND AND OBJECTIVES: Dysphagia and vocal cord palsy (VCP) are common 
      otolaryngological complications after revision anterior cervical discectomy and 
      fusion (rACDF) procedures. Our objective was to determine the early incidence and 
      risk factors of VCP and dysphagia after rACDF using a 2-team approach. METHODS: 
      Single-institution, retrospective analysis of a prospectively collected database 
      of patients undergoing rACDF was enrolled from September 2010 to July 2021. Of 
      222 patients enrolled, 109 patients were included in the final analysis. All 
      patients had prior ACDF surgery with planned revision using a single 
      otolaryngologist and single neurosurgeon. MD Anderson Dysphagia Inventory and 
      fiberoptic endoscopic evaluation of swallowing (FEES) were used to assess 
      dysphagia. VCP was assessed using videolaryngostroboscopy. RESULTS: Seven 
      patients (6.7%) developed new postoperative VCP after rACDF. Most cases of VCP 
      resolved by 3 months postoperatively (mean time-to-resolution 79 +/- 17.6 days). 
      One patient maintained a permanent deficit. Forty-one patients (37.6%) reached 
      minimum clinically important difference (MCID) in their MD Anderson Dysphagia 
      Inventory composite scores at the 2-week follow-up (MCID decline of >/=6), 
      indicating new clinically relevant swallowing disturbance. Forty-nine patients 
      (45.0%) had functional FEES Performance Score decline. On univariate analysis, 
      there was an association between new VCPs and the number of cervical levels 
      treated at revision ( P = .020) with long-segment rACDF (>/=4 levels) being an 
      independent risk factor ( P = .010). On linear regression, there was an 
      association between the number of levels treated previously and at revision for 
      FEES Performance Score decline ( P = .045 and P = .002, respectively). However, 
      on univariate analysis, sex, age, body mass index, operative time, alcohol use, 
      smoking, and individual levels revised were not risk factors for reaching FEES 
      Performance Score decline nor MCID at 2 weeks postoperatively. CONCLUSION: VCP is 
      more likely to occur in long-segment rACDF but is often temporary. Clinically 
      relevant and functional rates of dysphagia approach 37% and 45%, respectively, at 
      2 weeks postoperatively after rACDF.
CI  - Copyright (c) Congress of Neurological Surgeons 2023. All rights reserved.
FAU - Laskay, Nicholas M B
AU  - Laskay NMB
AD  - Department of Neurological Surgery, University of Alabama at Birmingham, 
      Birmingham , Alabama , USA.
FAU - Yang, Lydia C
AU  - Yang LC
AD  - Heersink School of Medicine, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Estevez-Ordonez, Dagoberto
AU  - Estevez-Ordonez D
AD  - Department of Neurological Surgery, University of Alabama at Birmingham, 
      Birmingham , Alabama , USA.
FAU - Warner, Jeffrey D
AU  - Warner JD
AD  - Heersink School of Medicine, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Trahan, Duane
AU  - Trahan D
AD  - Department of Otolaryngology, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Stone, Caitlin
AU  - Stone C
AD  - Department of Otolaryngology, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Grayson, Jessica W
AU  - Grayson JW
AD  - Department of Otolaryngology, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Withrow, Kirk
AU  - Withrow K
AD  - Department of Otolaryngology, University of Alabama at Birmingham, Birmingham , 
      Alabama , USA.
FAU - Hadley, Mark N
AU  - Hadley MN
AD  - Department of Neurological Surgery, University of Alabama at Birmingham, 
      Birmingham , Alabama , USA.
LA  - eng
PT  - Journal Article
DEP - 20231013
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Humans
MH  - Infant, Newborn
MH  - Deglutition
MH  - Retrospective Studies
MH  - *Deglutition Disorders/epidemiology/etiology/surgery
MH  - Incidence
MH  - Postoperative Complications/epidemiology/etiology/surgery
MH  - Diskectomy/adverse effects/methods
MH  - *Spinal Diseases/surgery
MH  - Risk Factors
MH  - *Spinal Fusion/adverse effects/methods
MH  - Cervical Vertebrae/surgery
MH  - Treatment Outcome
EDAT- 2023/10/13 12:43
MHDA- 2024/02/16 06:42
CRDT- 2023/10/13 09:03
PHST- 2023/06/02 00:00 [received]
PHST- 2023/08/01 00:00 [accepted]
PHST- 2024/02/16 06:42 [medline]
PHST- 2023/10/13 12:43 [pubmed]
PHST- 2023/10/13 09:03 [entrez]
AID - 00006123-990000000-00925 [pii]
AID - 10.1227/neu.0000000000002704 [doi]
PST - ppublish
SO  - Neurosurgery. 2024 Mar 1;94(3):444-453. doi: 10.1227/neu.0000000000002704. Epub 
      2023 Oct 13.