{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:03:52Z","timestamp":1772827432978,"version":"3.50.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,19]]},"abstract":"\n OBJECTIVE<\/jats:title>\n This study aimed to determine minimum clinically important difference (MCID) values for dysphagia using the Eating Assessment Tool-10 (EAT-10) in patients undergoing anterior cervical surgery, focusing on early dissatisfaction and later satisfaction thresholds to guide clinical decisions.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Data were prospectively collected from patients undergoing anterior cervical surgery across three institutions from 2016 to 2024. Dysphagia severity was assessed preoperatively and at various postoperative stages up to 1 year using EAT-10. The inverse probability of treatment weighting was used to control for confounding variables. The retrospective study of patient data employed two analytical phases: the first phase examined the relationship between dissatisfaction at 3 months (indicated by a North American Spine Society satisfaction score > 2) and changes in EAT-10 scores from baseline to peak (i.e., worst) postoperative scores; the second phase focused on recovery, comparing changes in EAT-10 scores from peak postoperative scores to 12 months against satisfaction (score < 2) at 12 months.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The mean \u00b1 SD baseline EAT-10 score for the 1463 patients included in the study was 1.5 \u00b1 4.7 and the mean peak score was 5.2 \u00b1 7.4. The patients underwent anterior cervical discectomy and fusion (90%), arthroplasty (6%), or corpectomy (4%); a hybrid procedure was used in 1%. The phase 1 analysis indicated that a 4-point increase in EAT-10 score was a threshold for significant postoperative dissatisfaction in those without baseline dysphagia, with much higher thresholds observed in patients with any baseline dysphagia. In phase 2, among patients with baseline EAT-10 scores < 3 who experienced an increase to EAT-10 score \u2265 8 postoperatively, a subsequent decrease of 9 points by 12 months was necessary to report satisfaction. For patients with baseline scores 3\u20138 whose postoperative scores rose to \u2265 8, a subsequent decrease of 15 points was necessary for satisfaction. Patients with initial scores of \u2265 8 who did not improve to < 3 immediately after surgery required further reductions of 2\u201311 points to reach satisfaction.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The MCID thresholds from this study provide crucial benchmarks for assessing dysphagia changes after anterior cervical surgery, allowing tailored interventions. Patients with baseline dysphagia are less likely to experience early dissatisfaction, and high peak scores negatively impact long-term satisfaction. These findings emphasize the importance of proactive dysphagia management to enhance patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.7.spine25551","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:08Z","timestamp":1769083208000},"page":"386-398","source":"Crossref","is-referenced-by-count":0,"title":["Minimum clinically important difference for dysphagia after anterior cervical spine surgery using EAT-10: the peak matters"],"prefix":"10.3171","volume":"44","author":[{"given":"Ken","family":"Porche","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"},{"name":"Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Semmes Murphey Clinic, Memphis, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"22","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"2453","article-title":"Incidence of dysphagia after anterior cervical spine surgery: a prospective study","volume":"27","author":"Bazaz R","year":"2002","unstructured":"Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976). 2002;27(22):2453\u20132458."},{"issue":"3","key":"b2","series-title":"J Neurosurg Spine","first-page":"382","article-title":"Dysphagia after cervical spine surgery: a review of risk factors and preventative measures","volume":"38","author":"Alentado VJ","year":"2023","unstructured":"Alentado VJ, Bisson EF, Potts EA. Dysphagia after cervical spine surgery: a review of risk factors and preventative measures. J Neurosurg Spine. 2023;38(3):382\u2013388."},{"issue":"2","key":"b3","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":"12","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"859","article-title":"Predictors of dysphagia after anterior cervical discectomy and fusion: a prospective multicenter study","volume":"47","author":"Nguyen S","year":"2022","unstructured":"Nguyen S, Sherrod BA, Paziuk TM, Predictors of dysphagia after anterior cervical discectomy and fusion: a prospective multicenter study. Spine (Phila Pa 1976). 2022;47(12):859\u2013864."},{"issue":"12","key":"b5","series-title":"Ann Otol Rhinol Laryngol","first-page":"919","article-title":"Validity and reliability of the Eating Assessment Tool (EAT-10)","volume":"117","author":"Belafsky PC","year":"2008","unstructured":"Belafsky PC, Mouadeb DA, Rees CJ, Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919\u2013924."},{"issue":"4","key":"b6","series-title":"J Neurogastroenterol Motil","first-page":"550","article-title":"The ability of the Eating Assessment Tool-10 to detect aspiration in patients with neurological disorders","volume":"23","author":"Arslan SS","year":"2017","unstructured":"Arslan SS, Demir N, K\u0131l\u0131n\u00e7 HE, Karaduman AA. The ability of the Eating Assessment Tool-10 to detect aspiration in patients with neurological disorders. J Neurogastroenterol Motil. 2017;23(4):550\u2013554."},{"issue":"1","key":"b7","series-title":"Otolaryngol Head Neck Surg","first-page":"92","article-title":"Utility of Eating Assessment Tool-10 in predicting aspiration in patients with unilateral vocal fold paralysis","volume":"159","author":"Zuniga SA","year":"2018","unstructured":"Zuniga SA, Ebersole B, Jamal N. Utility of Eating Assessment Tool-10 in predicting aspiration in patients with unilateral vocal fold paralysis. Otolaryngol Head Neck Surg. 2018;159(1):92\u201396."},{"issue":"1","key":"b8","series-title":"Dysphagia","first-page":"145","article-title":"Diagnostic accuracy of the Eating Assessment Tool-10 (EAT-10) in screening dysphagia: a systematic review and meta-analysis","volume":"38","author":"Zhang PP","year":"2023","unstructured":"Zhang PP, Yuan Y, Lu DZ, Diagnostic accuracy of the Eating Assessment Tool-10 (EAT-10) in screening dysphagia: a systematic review and meta-analysis. Dysphagia. 2023;38(1):145\u2013158."},{"issue":"5","key":"b9","series-title":"Eur Arch Otorhinolaryngol","first-page":"1661","article-title":"The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson\u2019s disease","volume":"278","author":"Schlickewei O","year":"2021","unstructured":"Schlickewei O, Nienstedt JC, Frank U, The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson\u2019s disease. Eur Arch Otorhinolaryngol. 2021;278(5):1661\u20131668."},{"issue":"4","key":"b10","series-title":"Control Clin Trials","first-page":"407","article-title":"Measurement of health status. Ascertaining the minimal clinically important difference","volume":"10","author":"Jaeschke R","year":"1989","unstructured":"Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10(4):407\u2013415."},{"issue":"2","key":"b11","series-title":"J Neurosurg Spine","first-page":"154","article-title":"Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article","volume":"18","author":"Parker SL","year":"2013","unstructured":"Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18(2):154\u2013160."},{"issue":"6","key":"b12","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, Short Form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, Short Form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"issue":"6","key":"b13","series-title":"Spine J","first-page":"968","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay AG","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8(6):968\u2013974."},{"issue":"11","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"717","article-title":"Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values","volume":"46","author":"Khan I","year":"2021","unstructured":"Khan I, Pennings JS, Devin CJ, Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values. Spine (Phila Pa 1976). 2021;46(11):717\u2013725."},{"issue":"5","key":"b15","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database","volume":"46","author":"Mummaneni PV","year":"2019","unstructured":"Mummaneni PV, Bydon M, Alvi MA, Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database. Neurosurg Focus. 2019;46(5):E12."},{"issue":"5","key":"b16","series-title":"J Neurosurg Spine","first-page":"658","article-title":"Predictors of patient satisfaction after surgery for grade 1 degenerative spondylolisthesis: a 5-year analysis of the Quality Outcomes Database","volume":"41","author":"Dru A","year":"2024","unstructured":"Dru A, Johnson SE, Linzey JR, Predictors of patient satisfaction after surgery for grade 1 degenerative spondylolisthesis: a 5-year analysis of the Quality Outcomes Database. J Neurosurg Spine. 2024;41(5):658\u2013665."},{"issue":"3","key":"b17","series-title":"J Chiropr Med","first-page":"113","article-title":"Subjective outcome assessments for cervical spine pathology: a narrative review","volume":"4","author":"Resnick DN","year":"2005","unstructured":"Resnick DN. Subjective outcome assessments for cervical spine pathology: a narrative review. J Chiropr Med. 2005;4(3):113\u2013134."},{"issue":"4","key":"b18","series-title":"Spine J","first-page":"598","article-title":"The patient acceptable symptom state for the Oswestry Disability Index following single-level lumbar fusion for degenerative spondylolisthesis","volume":"21","author":"Goh GS","year":"2021","unstructured":"Goh GS, Soh RCC, Yue WM, Guo CM, Tan SB, Chen JLT. The patient acceptable symptom state for the Oswestry Disability Index following single-level lumbar fusion for degenerative spondylolisthesis. Spine J. 2021;21(4):598\u2013609."},{"issue":"22","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"2453","article-title":"Incidence of dysphagia after anterior cervical spine surgery: a prospective study","volume":"27","author":"Bazaz R","year":"2002","unstructured":"Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976). 2002;27(22):2453\u20132458."},{"issue":"3","key":"b2","series-title":"J Neurosurg Spine","first-page":"382","article-title":"Dysphagia after cervical spine surgery: a review of risk factors and preventative measures","volume":"38","author":"Alentado VJ","year":"2023","unstructured":"Alentado VJ, Bisson EF, Potts EA. Dysphagia after cervical spine surgery: a review of risk factors and preventative measures. J Neurosurg Spine. 2023;38(3):382\u2013388."},{"issue":"2","key":"b3","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":"12","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"859","article-title":"Predictors of dysphagia after anterior cervical discectomy and fusion: a prospective multicenter study","volume":"47","author":"Nguyen S","year":"2022","unstructured":"Nguyen S, Sherrod BA, Paziuk TM, Predictors of dysphagia after anterior cervical discectomy and fusion: a prospective multicenter study. Spine (Phila Pa 1976). 2022;47(12):859\u2013864."},{"issue":"12","key":"b5","series-title":"Ann Otol Rhinol Laryngol","first-page":"919","article-title":"Validity and reliability of the Eating Assessment Tool (EAT-10)","volume":"117","author":"Belafsky PC","year":"2008","unstructured":"Belafsky PC, Mouadeb DA, Rees CJ, Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919\u2013924."},{"issue":"4","key":"b6","series-title":"J Neurogastroenterol Motil","first-page":"550","article-title":"The ability of the Eating Assessment Tool-10 to detect aspiration in patients with neurological disorders","volume":"23","author":"Arslan SS","year":"2017","unstructured":"Arslan SS, Demir N, K\u0131l\u0131n\u00e7 HE, Karaduman AA. The ability of the Eating Assessment Tool-10 to detect aspiration in patients with neurological disorders. J Neurogastroenterol Motil. 2017;23(4):550\u2013554."},{"issue":"1","key":"b7","series-title":"Otolaryngol Head Neck Surg","first-page":"92","article-title":"Utility of Eating Assessment Tool-10 in predicting aspiration in patients with unilateral vocal fold paralysis","volume":"159","author":"Zuniga SA","year":"2018","unstructured":"Zuniga SA, Ebersole B, Jamal N. Utility of Eating Assessment Tool-10 in predicting aspiration in patients with unilateral vocal fold paralysis. Otolaryngol Head Neck Surg. 2018;159(1):92\u201396."},{"issue":"1","key":"b8","series-title":"Dysphagia","first-page":"145","article-title":"Diagnostic accuracy of the Eating Assessment Tool-10 (EAT-10) in screening dysphagia: a systematic review and meta-analysis","volume":"38","author":"Zhang PP","year":"2023","unstructured":"Zhang PP, Yuan Y, Lu DZ, Diagnostic accuracy of the Eating Assessment Tool-10 (EAT-10) in screening dysphagia: a systematic review and meta-analysis. Dysphagia. 2023;38(1):145\u2013158."},{"issue":"5","key":"b9","series-title":"Eur Arch Otorhinolaryngol","first-page":"1661","article-title":"The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson\u2019s disease","volume":"278","author":"Schlickewei O","year":"2021","unstructured":"Schlickewei O, Nienstedt JC, Frank U, The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson\u2019s disease. Eur Arch Otorhinolaryngol. 2021;278(5):1661\u20131668."},{"issue":"4","key":"b10","series-title":"Control Clin Trials","first-page":"407","article-title":"Measurement of health status. Ascertaining the minimal clinically important difference","volume":"10","author":"Jaeschke R","year":"1989","unstructured":"Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10(4):407\u2013415."},{"issue":"2","key":"b11","series-title":"J Neurosurg Spine","first-page":"154","article-title":"Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article","volume":"18","author":"Parker SL","year":"2013","unstructured":"Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18(2):154\u2013160."},{"issue":"6","key":"b12","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, Short Form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, Short Form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"issue":"6","key":"b13","series-title":"Spine J","first-page":"968","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay AG","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8(6):968\u2013974."},{"issue":"11","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"717","article-title":"Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values","volume":"46","author":"Khan I","year":"2021","unstructured":"Khan I, Pennings JS, Devin CJ, Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values. Spine (Phila Pa 1976). 2021;46(11):717\u2013725."},{"issue":"5","key":"b15","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database","volume":"46","author":"Mummaneni PV","year":"2019","unstructured":"Mummaneni PV, Bydon M, Alvi MA, Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database. Neurosurg Focus. 2019;46(5):E12."},{"issue":"5","key":"b16","series-title":"J Neurosurg Spine","first-page":"658","article-title":"Predictors of patient satisfaction after surgery for grade 1 degenerative spondylolisthesis: a 5-year analysis of the Quality Outcomes Database","volume":"41","author":"Dru A","year":"2024","unstructured":"Dru A, Johnson SE, Linzey JR, Predictors of patient satisfaction after surgery for grade 1 degenerative spondylolisthesis: a 5-year analysis of the Quality Outcomes Database. J Neurosurg Spine. 2024;41(5):658\u2013665."},{"issue":"3","key":"b17","series-title":"J Chiropr Med","first-page":"113","article-title":"Subjective outcome assessments for cervical spine pathology: a narrative review","volume":"4","author":"Resnick DN","year":"2005","unstructured":"Resnick DN. Subjective outcome assessments for cervical spine pathology: a narrative review. J Chiropr Med. 2005;4(3):113\u2013134."},{"issue":"4","key":"b18","series-title":"Spine J","first-page":"598","article-title":"The patient acceptable symptom state for the Oswestry Disability Index following single-level lumbar fusion for degenerative spondylolisthesis","volume":"21","author":"Goh GS","year":"2021","unstructured":"Goh GS, Soh RCC, Yue WM, Guo CM, Tan SB, Chen JLT. The patient acceptable symptom state for the Oswestry Disability Index following single-level lumbar fusion for degenerative spondylolisthesis. Spine J. 2021;21(4):598\u2013609."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/3\/article-p386.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/3\/article-p386.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/3\/article-p386.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:09Z","timestamp":1772804709000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/3\/article-p386.xml"}},"subtitle":["Presented at the 2025 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":36,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2025.7.spine25551","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,19]]}}}