{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T01:48:58Z","timestamp":1749692938764,"version":"3.30.1"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The goal of this study was to compare rates of dysphagia and patient-reported outcomes (PROs) following long-segment (\u2265 3 levels) anterior cervical spinal fusion (ACF) and posterior cervical spinal fusion (PCF) at 3 and 12 months postoperatively. PROs were also compared for patients with dysphagia versus those without dysphagia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A prospectively collected quality improvement database was used to identify patients who had a long-segment cervical spinal fusion. Cohorts were divided into ACF and PCF groups. Eating Assessment Tool\u201310 scores and PROs were obtained for all patients preoperatively and at 3 and 12 months postoperatively to compare. Multivariate analysis was also performed to evaluate risk factors for dysphagia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 132 patients met the inclusion criteria, 77 of whom had undergone ACF and 55 of whom had undergone PCF. Dysphagia rates between ACF and PCF cohorts were similar at baseline (13.0% vs 18.2%, p = 0.4). New-onset dysphagia rates were also comparable at 3-month follow-up (39.7% vs 23.1%, p = 0.08) and 12-month follow-up (32.6% vs 32.4%, p &gt; 0.99). Patients who underwent PCF had worse Neck Disability Index (NDI) scores at 3 months than did patients with ACF (13.67 \u00b1 9.49 vs 10.55 \u00b1 6.24, respectively; p = 0.03). There were significantly higher NDI scores for patients with dysphagia at 3 months in both the ACF and PCF groups and at 12 months for those in the PCF group. Analogously, EuroQol\u20135 Dimensions scores were worse for patients with dysphagia; however, this was only significant for patients in the ACF group at 3 months. There were no significant risk factors for the development of dysphagia found on multivariate analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Similar rates and severity of dysphagia were seen following ACF and PCF at 3- and 12-month follow-up. This suggests that long-term dysphagia following cervical fusion surgery may be due to structural changes from the fusion rather than the surgical approach. However, the ACF cohort was significantly younger, and this may have partially accounted for the findings. PROs were also compared for patients with and without dysphagia, demonstrating worsened outcomes in some domains for patients who presented with dysphagia at 3- and 12-month follow-up. This suggests that dysphagia may be associated with a decreased quality of life after cervical fusion.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.spine24108","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T01:54:59Z","timestamp":1722650099000},"page":"628-638","source":"Crossref","is-referenced-by-count":1,"title":["A comparison of dysphagia rates between long-segment anterior versus posterior cervical fusion"],"prefix":"10.3171","volume":"41","author":[{"given":"Michael J.","family":"Visconti","sequence":"first","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Indiana University School of Medicine, Indianapolis; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent J.","family":"Alentado","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Department of Neurosurgery, Ascension St. Vincent Hospital, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian M.","family":"McFatridge","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Indiana University School of Medicine, Indianapolis; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Z.","family":"Neher","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Indiana University School of Medicine, Indianapolis; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Department of Neurosurgery, Ascension St. Vincent Hospital, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Curr Rev Musculoskelet Med","first-page":"263","article-title":"Degenerative cervical myelopathy","volume":"9","author":"Kato S","year":"2016","unstructured":"Kato S, Fehlings M. Degenerative cervical myelopathy. Curr Rev Musculoskelet Med. 2016;9(3):263\u2013271."},{"issue":"7","key":"b2","series-title":"Eur Spine J","first-page":"1583","article-title":"Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis","volume":"22","author":"Zhu B","year":"2013","unstructured":"Zhu B, Xu Y, Liu X, Liu Z, Dang G. Anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy: a systemic review and meta-analysis. Eur Spine J. 2013;22(7):1583\u20131593."},{"issue":"22","key":"b3","series-title":"Spine (Phila Pa 1976)","first-page":"2564","article-title":"Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study","volume":"30","author":"Riley LH III","year":"2005","unstructured":"Riley LH III, Skolasky RL, Albert TJ, Vaccaro AR, Heller JG. 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Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976). 2002;27(22):2453\u20132458."},{"issue":"11","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"996","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 M","year":"2012","unstructured":"Skeppholm M, Ingebro C, Engstr\u00f6m T, Olerud C. The Dysphagia Short Questionnaire: an instrument for evaluation of dysphagia: a validation study with 12 months\u2019 follow-up after anterior cervical spine surgery. 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Eur Arch Otorhinolaryngol. 2023;280(11):4793\u20134801."},{"issue":"2","key":"b13","series-title":"Spine (Phila Pa 1976)","first-page":"E82","article-title":"Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (ACDF) using the Eating Assessment Tool-10 (EAT-10)","volume":"44","author":"Yew AY","year":"2019","unstructured":"Yew AY, Nguyen MT, Hsu WK, Patel AA. Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (ACDF) using the Eating Assessment Tool-10 (EAT-10). Spine (Phila Pa 1976). 2019;44(2):E82\u2013E88."},{"issue":"7","key":"b14","series-title":"J Manipulative Physiol Ther","first-page":"491","article-title":"The Neck Disability Index: state-of-the-art, 1991-2008","volume":"31","author":"Vernon H","year":"2008","unstructured":"Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther. 2008;31(7):491\u2013502."},{"issue":"Suppl 1","key":"b15","series-title":"Eur Spine J","first-page":"S17","article-title":"Pain assessment","volume":"15","author":"Haefeli M","year":"2006","unstructured":"Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15(Suppl 1):S17-S24."},{"issue":"5","key":"b16","series-title":"Ann Med","first-page":"337","article-title":"EQ-5D: a measure of health status from the EuroQol Group","volume":"33","author":"Rabin R","year":"2001","unstructured":"Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337\u2013343."},{"issue":"3","key":"b17","series-title":"Health Policy","first-page":"199","article-title":"EuroQol\u2014a new facility for the measurement of health-related quality of life","volume":"16","year":"1990","unstructured":"EuroQol Group. EuroQol\u2014a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199\u2013208."},{"issue":"7","key":"b18","series-title":"Cureus","first-page":"e26888","article-title":"Dysphagia as a postoperative complication of anterior cervical discectomy and fusion","volume":"14","author":"Tsalimas G","year":"2022","unstructured":"Tsalimas G, Evangelopoulos DS, Benetos IS, Pneumaticos S. Dysphagia as a postoperative complication of anterior cervical discectomy and fusion. Cureus. 2022;14(7):e26888."},{"issue":"9","key":"b19","series-title":"Clin Spine Surg","first-page":"E1306","article-title":"The role of C2-C7 angle in the development of dysphagia after anterior and posterior cervical spine surgery","volume":"30","author":"Tian W","year":"2017","unstructured":"Tian W, Yu J. The role of C2-C7 angle in the development of dysphagia after anterior and posterior cervical spine surgery. Clin Spine Surg. 2017;30(9):E1306\u2013E1314."},{"issue":"4","key":"b20","series-title":"Clin Spine Surg","first-page":"E168","article-title":"Risk factors and assessment using an endoscopic scoring system for early and persistent dysphagia after anterior cervical decompression and fusion surgery","volume":"33","author":"Ohba T","year":"2020","unstructured":"Ohba T, Hatsushika K, Ebata S,  Risk factors and assessment using an endoscopic scoring system for early and persistent dysphagia after anterior cervical decompression and fusion surgery. Clin Spine Surg. 2020;33(4):E168\u2013E173."},{"issue":"3","key":"b21","series-title":"Ann Otol Rhinol Laryngol","first-page":"289","article-title":"Post-operative dysphagia in anterior cervical discectomy and fusion","volume":"131","author":"Haller L","year":"2022","unstructured":"Haller L, Mehul Kharidia K, Bertelsen C, Wang J, O\u2019Dell K. Post-operative dysphagia in anterior cervical discectomy and fusion. Ann Otol Rhinol Laryngol. 2022;131(3):289\u2013294."},{"issue":"34","key":"b22","series-title":"Medicine (Baltimore)","first-page":"e7916","article-title":"Factors predicting dysphagia after anterior cervical surgery: a multicenter retrospective study for 2 years of follow-up","volume":"96","author":"Wang T","year":"2017","unstructured":"Wang T, Ma L, Yang DL,  Factors predicting dysphagia after anterior cervical surgery: a multicenter retrospective study for 2 years of follow-up. Medicine (Baltimore). 2017;96(34):e7916."},{"issue":"7","key":"b23","series-title":"Spine J","first-page":"1080","article-title":"Risk factors for postoperative dysphagia and dysphonia following anterior cervical spine surgery: a comprehensive study utilizing the hospital for special surgery dysphagia and dysphonia inventory (HSS-DDI)","volume":"21","author":"Okano I","year":"2021","unstructured":"Okano I, Salzmann SN, Ortiz Miller C,  Risk factors for postoperative dysphagia and dysphonia following anterior cervical spine surgery: a comprehensive study utilizing the hospital for special surgery dysphagia and dysphonia inventory (HSS-DDI). Spine J. 2021;21(7):1080\u20131088."},{"issue":"10","key":"b24","series-title":"J Clin Neurosci","first-page":"1369","article-title":"Multi-level spinal fusion and postoperative prevertebral thickness increase the risk of dysphagia after anterior cervical spine surgery","volume":"18","author":"Kang SH","year":"2011","unstructured":"Kang SH, Kim DK, Seo KM, Kim KT, Kim YB. Multi-level spinal fusion and postoperative prevertebral thickness increase the risk of dysphagia after anterior cervical spine surgery. J Clin Neurosci. 2011;18(10):1369\u20131373."},{"issue":"9","key":"b25","series-title":"Spine (Phila Pa 1976)","first-page":"E528","article-title":"Postoperative prevertebral soft tissue swelling does not affect the development of chronic dysphagia following anterior cervical spine surgery","volume":"38","author":"Khaki F","year":"2013","unstructured":"Khaki F, Zusman NL, Nemecek AN, Ching AC, Hart RA, Yoo JU. Postoperative prevertebral soft tissue swelling does not affect the development of chronic dysphagia following anterior cervical spine surgery. Spine (Phila Pa 1976). 2013;38(9):E528\u2013E532."},{"issue":"3","key":"b26","series-title":"Clin Orthop Relat Res","first-page":"658","article-title":"What is the incidence and severity of dysphagia after anterior cervical surgery?","volume":"469","author":"Rihn JA","year":"2011","unstructured":"Rihn JA, Kane J, Albert TJ, Vaccaro AR, Hilibrand AS. What is the incidence and severity of dysphagia after anterior cervical surgery? Clin Orthop Relat Res. 2011;469(3):658\u2013665."},{"issue":"1","key":"b27","series-title":"World Neurosurg","first-page":"183","article-title":"Dysphagia after anterior cervical spine surgery: incidence and risk factors","volume":"77","author":"Kalb S","year":"2012","unstructured":"Kalb S, Reis MT, Cowperthwaite MC,  Dysphagia after anterior cervical spine surgery: incidence and risk factors. World Neurosurg. 2012;77(1):183\u2013187."},{"issue":"4","key":"b28","series-title":"Br J Neurosurg","first-page":"457","article-title":"Analysis of postoperative dysphagia after anterior cervical decompression and fusion","volume":"34","author":"Park JH","year":"2020","unstructured":"Park JH, Lee SH, Kim ES, Eoh W. Analysis of postoperative dysphagia after anterior cervical decompression and fusion. Br J Neurosurg. 2020;34(4):457\u2013462."},{"issue":"2","key":"b29","series-title":"Spine J","first-page":"141","article-title":"Risk factors for dysphagia after anterior cervical spine surgery: a two-year prospective cohort study","volume":"7","author":"Lee MJ","year":"2007","unstructured":"Lee MJ, Bazaz R, Furey CG, Yoo J. Risk factors for dysphagia after anterior cervical spine surgery: a two-year prospective cohort study. Spine J. 2007;7(2):141\u2013147."},{"issue":"5","key":"b30","series-title":"Spine J","first-page":"737","article-title":"Is the likelihood of dysphagia different in patients undergoing one-level versus two-level anterior cervical discectomy and fusion?","volume":"20","author":"Vaishnav AS","year":"2020","unstructured":"Vaishnav AS, Saville P, McAnany S,  Is the likelihood of dysphagia different in patients undergoing one-level versus two-level anterior cervical discectomy and fusion? Spine J. 2020;20(5):737\u2013744."},{"issue":"21","key":"b31","series-title":"Spine (Phila Pa 1976)","first-page":"1820","article-title":"Incidence and risk factors for dysphagia after anterior cervical fusion","volume":"38","author":"Singh K","year":"2013","unstructured":"Singh K, Marquez-Lara A, Nandyala SV, Patel AA, Fineberg SJ. Incidence and risk factors for dysphagia after anterior cervical fusion. Spine (Phila Pa 1976). 2013;38(21):1820\u20131825."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/5\/article-p628.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/5\/article-p628.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/5\/article-p628.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:20:35Z","timestamp":1733491235000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/5\/article-p628.xml"}},"subtitle":["Presented at the 2024 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":31,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2024.4.spine24108","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}