{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:49:48Z","timestamp":1787755788231,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dysphagia is a common postoperative complaint following anterior cervical discectomy and fusion (ACDF), with incidence rates ranging from 1.7% to 71%. The variability in incidence rates raises the question of whether dysphagia warrants clinical concern or represents a transient, expected symptom. The aim of this study was to characterize the time course and impact of dysphagia following anterior cervical surgery for degenerative pathology with use of both subjective and objective measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients undergoing either lumbar or cervical spine surgery from 2023 to 2024 were prospectively enrolled. Lumbar cases were limited to 1 to 2-level, decompression-only procedures, whereas cervical cases included up to 3-level ACDF and\/or cervical disc replacement (CDR). Dysphagia was assessed using the Eating Assessment Tool (EAT-10) and the Yale Swallow Protocol at 5 time points: preoperatively and on postoperative days (PODs) 0, 3, 7, and 30. Postoperative responses were collected electronically. Retropharyngeal radiographic measurements at C3-C7 were obtained preoperatively, immediately postoperatively, and at the first follow-up. Measurements were taken from the vertebral midbody to the posterior airway space.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 134 patients (67 in the cervical group and 67 in the lumbar group) were included. The groups were demographically similar, although the cervical group had a longer mean operative time (86.7 versus 62.2 minutes; p &lt; 0.001). Dysphagia was more prevalent in the cervical group across all postoperative time points: POD0 (70.1% versus 13.4%), POD3 (64.2% versus 10.4%), POD7 (40.3% versus 6.0%), and POD30 (35.8% versus 4.5%) (all p \u2264 0.001). EAT-10 scores correlated strongly across postoperative time points and modestly with procedure duration. Male sex was associated with lower EAT-10 scores through POD7 (p &lt; 0.001). Intraoperative steroid use trended toward reduced EAT-10 scores but was not significant after correction. Retropharyngeal measurements increased immediately postoperatively (notably at C3, C4, C5, and C7), but swelling resolved by the time of follow-up, except at C3 and C4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Dysphagia was frequent after anterior cervical surgery, peaking early and partially resolving by 1 month. These findings support its characterization as a common, self-limited postoperative symptom rather than a true complication in most cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.25.00847","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T19:00:15Z","timestamp":1766775615000},"page":"436-442","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Subjective and Functional Dysphagia After Anterior Cervical Spine Surgery"],"prefix":"10.2106","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4787-1538","authenticated-orcid":false,"given":"Philip K.","family":"Louie","sequence":"first","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6398-5068","authenticated-orcid":false,"given":"Patricia","family":"Lipson","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"},{"name":"School of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8114-5727","authenticated-orcid":false,"given":"Murad","family":"Alostaz","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6787-5501","authenticated-orcid":false,"given":"Aiyush","family":"Bansal","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7379-2235","authenticated-orcid":false,"given":"Maxey","family":"Cherel","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"},{"name":"School of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6738-5388","authenticated-orcid":false,"given":"Laura","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"},{"name":"Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-8934","authenticated-orcid":false,"given":"Jesse","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery, CHUM, University of Montreal, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7351-7539","authenticated-orcid":false,"given":"Nicholas","family":"Eley","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1471-5814","authenticated-orcid":false,"given":"Eric","family":"Varley","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2465-444X","authenticated-orcid":false,"given":"Jean-Christophe","family":"Leveque","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8895-7090","authenticated-orcid":false,"given":"Venu M.","family":"Nemani","sequence":"additional","affiliation":[{"name":"Center for Neurosciences and Spine, Virginia Mason Medical Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"issue":"3","key":"bib1-20260615","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s11999-010-1731-8","article-title":"What is the incidence and severity of dysphagia after anterior cervical surgery?","volume":"469","author":"Rihn","year":"2011","journal-title":"Clin Orthop Relat Res."},{"issue":"12","key":"bib2-20260615","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/BRS.0000000000004279","article-title":"Predictors of Dysphagia After Anterior Cervical Discectomy and Fusion: A Prospective Multicenter Study","volume":"47","author":"Nguyen","year":"2022","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib3-20260615","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s00455-007-9127-y","article-title":"Clinical utility of the 3-ounce water swallow test","volume":"23","author":"Suiter","year":"2008","journal-title":"Dysphagia."},{"issue":"2","key":"bib4-20260615","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s00455-013-9488-3","article-title":"Validation of the Yale Swallow Protocol: a prospective double-blinded videofluoroscopic study","volume":"29","author":"Suiter","year":"2014","journal-title":"Dysphagia."},{"issue":"3","key":"bib5-20260615","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s00455-008-9204-x","article-title":"Answering orientation questions and following single-step verbal commands: effect on aspiration status","volume":"24","author":"Leder","year":"2009","journal-title":"Dysphagia."},{"issue":"3","key":"bib6-20260615","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s00455-012-9442-9","article-title":"Can an oral mechanism examination contribute to the assessment of odds of aspiration?","volume":"28","author":"Leder","year":"2013","journal-title":"Dysphagia."},{"issue":"11","key":"bib7-20260615","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1097\/BRS.0b013e31823a7a5b","article-title":"The Dysphagia Short Questionnaire: an instrument for evaluation of dysphagia: a validation study with 12 months\u2019 follow-up after anterior cervical spine surgery","volume":"37","author":"Skeppholm","year":"2012","journal-title":"Spine (Phila Pa 1976)."},{"issue":"7","key":"bib8-20260615","first-page":"870","article-title":"The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. 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Anderson dysphagia inventory","volume":"127","author":"Chen","year":"2001","journal-title":"Arch Otolaryngol Head Neck Surg."},{"issue":"12","key":"bib9-20260615","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1177\/000348940811701210","article-title":"Validity and reliability of the eating assessment tool (EAT-10)","volume":"117","author":"Belafsky","year":"2008","journal-title":"Ann Otol Rhinol Laryngol."},{"issue":"4","key":"bib11-20260615","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s00264-005-0072-9","article-title":"Prevertebral soft tissue swelling after anterior cervical discectomy and fusion with plate fixation","volume":"30","author":"Suk","year":"2006","journal-title":"Int Orthop."},{"issue":"9","key":"bib12-20260615","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.spinee.2017.05.003","article-title":"The natural course of prevertebral soft tissue swelling after anterior cervical spine surgery: how long will it last?","volume":"17","author":"Kim","year":"2017","journal-title":"Spine J."},{"issue":"2","key":"bib13-20260615","doi-asserted-by":"crossref","first-page":"244","DOI":"10.3171\/2010.9.SPINE09828","article-title":"Analysis of prevertebral soft-tissue swelling and dysphagia in multilevel anterior cervical discectomy and fusion with recombinant human bone morphogenetic protein-2 in patients at risk for pseudarthrosis","volume":"14","author":"Stachniak","year":"2011","journal-title":"J Neurosurg Spine."},{"issue":"13","key":"bib14-20260615","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/01.BRS.0000129100.59913.EA","article-title":"Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures","volume":"29","author":"Smith-Hammond","year":"2004","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib15-20260615","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/00024720-200210000-00004","article-title":"Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment","volume":"15","author":"Frempong-Boadu","year":"2002","journal-title":"J Spinal Disord Tech."},{"issue":"7","key":"bib16-20260615","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1302\/0301-620X.95B7.31029","article-title":"Dysphagia following anterior cervical spinal surgery: a systematic review","volume":"95-B","author":"Cho","year":"2013","journal-title":"Bone Joint J."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.25.00847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:53:12Z","timestamp":1787752392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.25.00847"}},"subtitle":["A Prospective Controlled Study"],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.25.00847","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,26]]}}}