{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:26:19Z","timestamp":1793978779637,"version":"4.8.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Dysphagia has been shown to have an adverse effect on patient quality of life following cervical spine surgery, but its impact on patients\u2019 ability to return to work (RTW) and return to physical activities (RTA) has never been investigated. This study aimed to evaluate the impact of postoperative dysphagia on patients\u2019 ability to RTW and RTA after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A prospectively maintained multi-institutional spine registry of patients who underwent cervical spine surgery between 2016 and 2023 was retrospectively reviewed. An Eating Assessment Tool-10 (EAT-10) score \u2265 3 was used to quantify preoperative and 12-month postoperative dysphagia. Prolonged dysphagia was defined as new dysphagia present at 12 months among patients without baseline dysphagia. RTW and RTA were assessed at baseline and 12 months postoperatively. Mixed-effects logistic regressions were used to evaluate the effect of dysphagia on RTW and RTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 1208 patients meeting inclusion criteria, 240 (20%) experienced prolonged dysphagia, of whom 208 (87%) underwent anterior surgery. Preoperatively, 709 (59%) patients were fully employed or on short-term leave, 307 (25%) were retired, and 191 (16%) were otherwise unemployed. At the 12-month follow-up, RTW and RTA status were collected for 629 (95%) of the 664 employed patients who planned to RTW after surgery and 1127 (93%) of the total cohort, respectively. Significantly lower rates of RTW (86% vs 96%, p &lt; 0.001) and RTA (62% vs 79%, p &lt; 0.001) were observed in patients with prolonged dysphagia. Multivariable analysis identified dysphagia as being independently associated with lower odds of RTW (OR 0.35, 95% CI 0.14\u20130.86; p = 0.022) and RTA (OR 0.44, 95% CI 0.31\u20130.63; p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Prolonged postoperative dysphagia\u2014defined as a new EAT-10 score \u2265 3 at 12 months\u2014was associated with substantially lower odds of returning to work and physical activities after cervical spine surgery, underscoring the importance of dysphagia prevention and management in postoperative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.3.spine251536","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:02:10Z","timestamp":1785888130000},"page":"632-642","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged postoperative dysphagia reduces return to work and physical activity after cervical spine surgery"],"prefix":"10.3171","volume":"45","author":[{"given":"Nathan J.","family":"Kussow","sequence":"first","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas P.","family":"Tippins","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Foreit","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Milne","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya M.","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Neely","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake T.","family":"Reasoner","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Hannon","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan C.","family":"Rezner","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Porche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah;"},{"name":"Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Semmes Murphey Neurologic and Spine Institute, Memphis; and"},{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosurg Spine","first-page":"400","article-title":"Arthroplasty for cervical spondylotic myelopathy: similar results to patients with only radiculopathy at 3 years\u2019 follow-up: clinical article","volume":"21","author":"Fay LY","year":"2014","unstructured":"Fay LY, Huang WC, Wu JC,  Arthroplasty for cervical spondylotic myelopathy: similar results to patients with only radiculopathy at 3 years\u2019 follow-up: clinical article. J Neurosurg Spine. 2014;21(3):400\u2013410. doi:10.3171\/2014.3.SPINE13387"},{"issue":"9","key":"b2","series-title":"Rev Assoc Med Bras (1992)","first-page":"886","article-title":"Management of degenerative cervical myelopathy\u2014an update","volume":"62","author":"Joaquim AF","year":"2016","unstructured":"Joaquim AF, Ghizoni E, Tedeschi H, Hsu WK, Patel AA. Management of degenerative cervical myelopathy\u2014an update. Rev Assoc Med Bras (1992). 2016;62(9):886\u2013894. doi:10.1590\/1806-9282.62.09.886"},{"issue":"15","key":"b3","series-title":"Spine (Phila Pa 1976)","first-page":"E906","article-title":"Trends in utilization and cost of cervical spine surgery using the National Inpatient Sample Database, 2001 to 2013","volume":"42","author":"Liu CY","year":"2017","unstructured":"Liu CY, Zygourakis CC, Yoon S,  Trends in utilization and cost of cervical spine surgery using the National Inpatient Sample Database, 2001 to 2013. Spine (Phila Pa 1976). 2017;42(15):E906\u2013E913. doi:10.1097\/BRS.0000000000001999"},{"key":"b4","series-title":"World Neurosurg","first-page":"e175","article-title":"Predicting trends in cervical spinal surgery in the United States from 2020 to 2040","volume":"141","author":"Neifert SN","year":"2020","unstructured":"Neifert SN, Martini ML, Yuk F,  Predicting trends in cervical spinal surgery in the United States from 2020 to 2040. World Neurosurg. 2020;141:e175\u2013e181. doi:10.1016\/j.wneu.2020.05.055"},{"issue":"3","key":"b5","series-title":"J Spine Surg","first-page":"581","article-title":"Dysphagia rates in single- and multiple-level anterior cervical discectomy and fusion surgery: a meta-analysis","volume":"6","author":"Oh LJ","year":"2020","unstructured":"Oh LJ, Ong S, Ghozy S,  Dysphagia rates in single- and multiple-level anterior cervical discectomy and fusion surgery: a meta-analysis. 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Spine (Phila Pa 1976). 2023;48(4):253\u2013260. doi:10.1097\/BRS.0000000000004482"},{"issue":"5","key":"b16","series-title":"Eur Spine J","first-page":"631","article-title":"Sickness absence and concurrent low back and neck\u2013shoulder pain: results from the MUSIC-Norrt\u00e4lje study","volume":"16","author":"Nyman T","year":"2007","unstructured":"Nyman T, Grooten WJA, Wiktorin C, Liwing J, Norrman L. Sickness absence and concurrent low back and neck\u2013shoulder pain: results from the MUSIC-Norrt\u00e4lje study. 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