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A cohort study of the morbidity of combined anterior-posterior cervical spinal fusions: incidence and predictors of postoperative dysphagia

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Abstract

Purpose

To identify risk factors that may lead to the development of dysphagia after combined anterior and posterior (360°) cervical fusion surgery.

Methods

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.

Results

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).

Conclusion

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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Authors and Affiliations

  1. Department of Neurosurgery, K-11, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202, USA

    Kevin A. Reinard, Hesham M. Zakaria, Azam M. Basheer, Victor W. Chang & Muwaffak M. Abdulhak

  2. Division of Speech and Language Pathology, Henry Ford Hospital, Detroit, MI, USA

    Diana M. Cook

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  1. Kevin A. Reinard
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  2. Diana M. Cook
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  3. Hesham M. Zakaria
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Correspondence to Kevin A. Reinard.

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Reinard, K.A., Cook, D.M., Zakaria, H.M. et al. A cohort study of the morbidity of combined anterior-posterior cervical spinal fusions: incidence and predictors of postoperative dysphagia. Eur Spine J 25, 2068–2077 (2016). https://doi.org/10.1007/s00586-016-4429-0

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  • DOI: https://doi.org/10.1007/s00586-016-4429-0

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