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颈椎前路手术后的吞咽困难与满意度:一项前瞻性观察试验

Dysphagia and Satisfaction Following Anterior Cervical Spine Surgery: A Prospective Observation Trial.

作者信息

Paziuk Taylor, Henry Tyler, Koons Katelyn, Conaway William, Mangan John, Hilibrand Alan, Vaccaro Alexander, Rihn Jeffrey

机构信息

Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA.

出版信息

Clin Spine Surg. 2022 Feb 1;35(1):E99-E103. doi: 10.1097/BSD.0000000000001112.

Abstract

STUDY DESIGN

Prospective observation.

OBJECTIVE

To assess the effect of dysphagia on patient satisfaction following anterior cervical discectomy and fusion.

BACKGROUND

Difficulty with swallowing is a common complaint following anterior cervical spine surgery. The exact impact of this issue on the patient's overall satisfaction is unknown because of its often-transient nature.

MATERIALS AND METHODS

A prospective evaluation of all patients from a single surgeon undergoing an anterior cervical spine surgery. Dysphagia was evaluated both preoperatively and postoperatively at set intervals via a combination of 3 validated scoring systems. Mean satisfaction scores at 6 months was evaluated at 6 months via modified CSRS survey. Comparative analysis was performed to determine if there was any relationship between the 2 outcomes.

RESULTS

A total of 96.77% (68/71) of enrolled patients completed all of their follow-up surveys. The prevalence of dysphagia was 32.4% at 2 weeks after surgery, 20.6% at 6 weeks, 13.2% at 3 months, and 13.2% at 6 months. In total, 82.35% (56/68) of patients were satisfied with their surgical outcome and only 5.88% (4/68) were dissatisfied with their outcome. There was no relationship between a patient's overall satisfaction level and the presence of dysphagia at any postoperative interval. The absence of neck pain at 6 months was the only significant predictor of patient satisfaction (P=0.003).

CONCLUSION

Dysphagia is a common but often transient complaint following anterior cervical spine surgery. Fortunately, its presence does not seem to correlate with a patient's overall satisfaction level following surgery.

LEVEL OF EVIDENCE

Level I.

摘要

研究设计

前瞻性观察。

目的

评估吞咽困难对颈椎前路椎间盘切除融合术后患者满意度的影响。

背景

吞咽困难是颈椎前路手术后常见的主诉。由于其通常为短暂性,该问题对患者总体满意度的确切影响尚不清楚。

材料与方法

对一位外科医生实施的所有颈椎前路手术患者进行前瞻性评估。通过3种经过验证的评分系统组合,在术前和术后定期评估吞咽困难情况。通过改良的CSRS调查在6个月时评估平均满意度得分。进行对比分析以确定这两个结果之间是否存在任何关联。

结果

共有96.77%(68/71)的入组患者完成了所有随访调查。术后2周吞咽困难的发生率为32.4%,6周时为20.6%,3个月时为13.2%,6个月时为小13.2%。总体而言,82.35%(56/68)的患者对手术结果满意,只有5.88%(4/68)的患者对结果不满意。在术后任何时间段,患者的总体满意度水平与吞咽困难的存在之间均无关联。术后6个月无颈部疼痛是患者满意度的唯一显著预测因素(P = 0.003)。

结论

吞咽困难是颈椎前路手术后常见但通常为短暂性的主诉。幸运的是,其存在似乎与患者术后的总体满意度水平无关。

证据级别

I级。

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