Wu Bing, Song Fei, Zhu Shourong
*Orthopaedic Hospital, General Hospital of PLA †Department of Orthopaedics, Beijing Tsinghua Chang Gung Hospital, Tsinghua University, Beijing, China.
Clin Spine Surg. 2017 Jun;30(5):E554-E559. doi: 10.1097/BSD.0000000000000180.
Retrospective study.
To analyze the reasons, clinical manifestation, risk factors, prevention, and treatment of dysphagia after operation of anterior cervical decompression and fusion (ACDF).
Dysphagia is one of severe complications after ACDF. There were a few studies about reasons and prevention of dysphagia.
We retrospectively reviewed medical charts of patients who underwent ACDF in our hospital from January 2012 to December 2012. Clinical symptom of dysphagia was recorded at the perioperative period and at the third and sixth month of the follow-up after surgery and assigned according to the Bazaz dysphagia score. We analyzed the reasons and risk factors leading to dysphagia and tried to find effective programs of prevention and treatment.
There were 358 patients who underwent ACDF. Of 358 patients, 39 patients including 14 men and 25 women complained of dysphagia. The mean age was 46.8 years, with an age range of 38-67 years. Clinical manifestation of dysphagia included difficulty to swallow, pain during swallowing, sticky throat feeling, and choking. All the patients were followed up over 6 months. The incidences of dysphagia were 10.9%, 6.4%, and 2.7%, respectively, at 1-5 days, 3 months, and 6 months after surgery. There was no severe dysphagia at 3 months after surgery. Mild or moderate dysphagia slightly affected the quality of life. Logistic regression showed multilevel cervical spine, and high-level cervical spine surgeries are high-risk factors for postoperative dysphagia.
Dysphagia is a common complication of ACDF. Causes of dysphagia include multilevel cervical spine and upper cervical spine surgeries. Use of methylprednisolone and careful operation can reduce the incidence and result in good prognosis.
回顾性研究。
分析颈椎前路减压融合术（ACDF）术后吞咽困难的原因、临床表现、危险因素、预防及治疗方法。
吞咽困难是ACDF术后的严重并发症之一。关于吞咽困难的原因及预防的研究较少。
我们回顾性分析了2012年1月至2012年12月在我院接受ACDF手术患者的病历。记录围手术期及术后随访第3个月和第6个月时吞咽困难的临床症状，并根据巴扎兹吞咽困难评分进行评定。我们分析了导致吞咽困难的原因和危险因素，并试图找到有效的预防和治疗方案。
共有358例患者接受了ACDF手术。在这358例患者中，39例患者（14例男性和25例女性）主诉有吞咽困难。平均年龄为46.8岁，年龄范围为38 - 67岁。吞咽困难的临床表现包括吞咽困难、吞咽时疼痛、咽部有黏着感和呛咳。所有患者均随访6个月以上。术后1 - 5天、3个月和6个月时吞咽困难的发生率分别为10.9%、6.4%和2.7%。术后3个月时无严重吞咽困难。轻度或中度吞咽困难对生活质量有轻微影响。逻辑回归显示多节段颈椎及高位颈椎手术是术后吞咽困难的高危因素。
吞咽困难是ACDF常见的并发症。吞咽困难的原因包括多节段颈椎和高位颈椎手术。使用甲基强的松龙并仔细操作可降低发生率并取得良好预后。
