Risk factors of dysphagia after single-level anterior cervical surgery
10.3760/cma.j.issn.0253-2352.2018.02.001
- VernacularTitle:单节段颈椎前路术后吞咽困难的危险因素研究
- Author:
Suozhou YAN
1
;
Xiaoyu WANG
;
Lingde KONG
;
Jun DI
;
Wenyuan DING
;
Jingtao ZHANG
;
Sidong YANG
;
Jia LI
;
Linfeng WANG
;
Yong SHEN
Author Information
1. 河北医科大学第三医院脊柱骨科
- Keywords:
Cervical vertebrae;
Spinal fusion;
Total disc replacement;
Deglutition disorders;
Risk factors
- From:
Chinese Journal of Orthopaedics
2018;38(2):65-71
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the incidence of dysphagia and its potential risk factors.Methods From January 2014 to December 2015,a total of 187 patients who underwent single-level anterior cervical spine surgery were recruited in this retrospective analysis study.Specific perioperative data including age,gender,smoking,alcohol use,BMI,estimated blood loss,surgical segment,length of incision,and length of hospital stay were recorded respectively.The Bazaz grading system and the swallowing quality of life (SWAL-QOL) score were used to assess the presence and severity of dysphagia.According to the Bazaz grading system,the patients were divided into dysphagia group and non-dysphagia group 1 week after operation.One-factor x2 test and one-sample t test were used to univariate analyze the two groups of related factors,and select the potential variables for multivariate logistic regression analysis to identify the risk factors leading to dysphagia.Results The number of dysphagia patient was 99 (52.94％) at 1 week after surgery,and 16 (8.56％) at 1 year.The preoperative mean SWAL-QOL score was 65.62±4.41 points,which decreased to 58.72±7.54 points after surgery and rose up to 64.66±5.26 points at the 12-month follow-up.The SWAL-QOL score at 1 week after surgery was correlated with the operative time (r=-0.474;P ＜ 0.001).Multivariate analysis indicated that preoperative tracheal exercise (OR=0.302,95％CI:0.131,0.748),operation time ＜ 60 min (OR=0.407,95％CI:0.190,0.878),and arthroplasty (OR=0.211,95％CI:0.102,0.425) were the independent factors to reduce the incidence of postoperative dysphagia.Conclusion The incidence and severity of dysphagia symptoms after single-level anterior cervical spine surgery gradually decreased with the extension of follow-up time.Preoperative tracheal exercise,shortened operative time and manual artificial disc replacement may be helpful to reduce the postoperative occurrence of dysphagia.
