Department of Spine Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
Department of Bone & Joint Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
BMC Musculoskelet Disord. 2024 May 10;25(1):369. doi: 10.1186/s12891-024-07461-7.
One goal of Anterior Cervical Discectomy and Fusion (ACDF) is to restore the loss of intervertebral disc height (IDH) results from the degenerative process. However, the effects of IDH on postoperative dysphagia after ACDF remain unclear.
Based on the results of a one-year telephone follow-up, A total of 217 consecutive patients after single-level ACDF were enrolled. They were divided into dysphagia and non-dysphagia groups. The age, BMI, operation time and blood loss of all patients were collected from the medical record system and compared between patients with and without dysphagia. Radiologically, IDH, spinous process distance (SP) of the operated segment, and C2-7 angle (C2-7 A) were measured preoperatively and postoperatively. The relationship between changes in these radiological parameters and the development of dysphagia was analyzed.
Sixty-three (29%) cases exhibited postoperative dysphagia. The mean changes in IDH, SP, and C2-7 A were 2.84 mm, -1.54 mm, and 4.82 degrees, respectively. Changes in IDH (P = 0.001) and changes in C2-7 A (P = 0.000) showed significant differences between dysphagia and non-dysphagia patients. Increased IDH and increased C2-7 A (P = 0.037 and 0.003, respectively) significantly and independently influenced the incidence of postoperative dysphagia. When the change in IDH was ≥ 3 mm, the chance of developing postoperative dysphagia for this patient was significantly greater. No significant relationship was observed between the change in spinous process distance (SP) and the incidence of dysphagia. The age, BMI, operation time and blood loss did not significantly influence the incidence of postoperative dysphagia.
The change in IDH could be regarded as a predictive factor for postoperative dysphagia after single-level ACDF.
颈椎前路椎间盘切除融合术（ACDF）的一个目标是恢复因退行性过程而导致的椎间盘高度（IDH）丧失。然而，IDH 对 ACDF 后吞咽困难的影响尚不清楚。
基于一年的电话随访结果，共纳入 217 例接受单节段 ACDF 的连续患者。他们被分为吞咽困难组和非吞咽困难组。从病历系统中收集所有患者的年龄、BMI、手术时间和出血量，并比较吞咽困难患者和非吞咽困难患者之间的差异。影像学上，术前和术后测量 IDH、手术节段棘突间距离（SP）和 C2-7 角（C2-7 A）。分析这些影像学参数变化与吞咽困难发展之间的关系。
63 例（29%）出现术后吞咽困难。IDH、SP 和 C2-7 A 的平均变化分别为 2.84mm、-1.54mm 和 4.82 度。吞咽困难患者和非吞咽困难患者的 IDH 变化（P=0.001）和 C2-7 A 变化（P=0.000）有显著差异。IDH 变化（P=0.001）和 C2-7 A 变化（P=0.000）显著且独立影响术后吞咽困难的发生。当 IDH 变化≥3mm 时，患者发生术后吞咽困难的可能性显著增加。棘突间距离（SP）的变化与吞咽困难的发生率之间无显著关系。年龄、BMI、手术时间和出血量与术后吞咽困难的发生率无显著关系。
IDH 的变化可作为单节段 ACDF 后术后吞咽困难的预测因素。
