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多节段颈椎后凸畸形伴曲度不良行前路手术后吞咽困难的相关危险因素。

Risk factors associated with dysphagia after anterior surgery in treatment for multilevel cervical disorder with kyphosis.

机构信息

Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Peking University Aerospace School of Clinical Medicine, Beijing, China.

出版信息

Medicine (Baltimore). 2022 Aug 5;101(31):e30009. doi: 10.1097/MD.0000000000030009.

Abstract

This is a retrospective study. Our aim was to investigate the risk factors related to dysphagia following anterior surgery treating the multilevel cervical disorder with kyphosis based on a subgroup of follow-up time. Finally, a total of 81 patients suffering from the multilevel cervical disorder with kyphosis following anterior surgery from July 2018 to June 2020 were included in our study. Patients with dysphagia were defined as the dysphagia group and without dysphagia as the no-dysphagia (NG) group based on a subgroup of follow-up time (1-week, 1-month, 3-month, 6-month, and 1-year after surgery). Clinical outcomes and radiological data were performed to compare between dysphagia group and NG. In our study, the rate of dysphagia was 67.9%, 44.4%, 34.6%, 25.9%, and 14.8% at 1-week, 1-month, 3-month, 6-month, and 1-year after surgery, respectively. Our findings showed that change of Cobb angle of C2-7 was associated with dysphagia within 3-month after surgery. Furthermore, postoperative Cobb angle of C2-7 was linked to dysphagia within 6-month after surgery. Interestingly, a history of smoking and lower preoperative SWAL-QOL score were found to be risk factors related with dysphagia at any follow-up. In the present study, many factors were found to be related to dysphagia within 3-month after surgery. Notably, a history of smoking and lower preoperative SWAL-QOL score were associated with dysphagia at any follow-up. We hope this article can provide a reference for spinal surgeons to predict which patients were susceptible to suffering from dysphagia after anterior surgery in the treatment of multilevel cervical disorder with kyphosis.

摘要

这是一项回顾性研究。我们的目的是基于随访时间的亚组,研究与多节段颈椎后凸伴前侧手术相关的吞咽困难的危险因素。最终,我们纳入了 2018 年 7 月至 2020 年 6 月因多节段颈椎后凸伴前侧手术的 81 例患者。基于随访时间(术后 1 周、1 个月、3 个月、6 个月和 1 年),将出现吞咽困难的患者定义为吞咽困难组,无吞咽困难的患者定义为无吞咽困难组(NG 组)。比较吞咽困难组和 NG 组的临床结果和影像学数据。在我们的研究中,术后 1 周、1 个月、3 个月、6 个月和 1 年的吞咽困难发生率分别为 67.9%、44.4%、34.6%、25.9%和 14.8%。我们的研究结果表明,C2-7 角的变化与术后 3 个月内的吞咽困难有关。此外,术后 C2-7 角与术后 6 个月内的吞咽困难有关。有趣的是,吸烟史和术前 SWAL-QOL 评分较低与任何随访时的吞咽困难相关。在本研究中,发现许多因素与术后 3 个月内的吞咽困难有关。值得注意的是,吸烟史和术前 SWAL-QOL 评分较低与任何随访时的吞咽困难有关。我们希望本文能为脊柱外科医生提供参考,预测哪些患者在前侧手术治疗多节段颈椎后凸伴后凸畸形后易发生吞咽困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2855/9351927/084a3daf6013/medi-101-e30009-g001.jpg

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