Shimizu Tomoaki, Inomata Kento, Tatsumura Masaki, Nakagawa Takane, Ogata Yosuke, Okuwaki Shun, Sakashita Kotaro, Sunami Takahiro, Gamada Hisanori, Nagasawa Keigo, Nagashima Katsuya, Takeuchi Yosuke, Shiina Itsuo, Hakoiwa Atsuo, Ainoya Takeshi, Miura Kousei, Noguchi Hiroshi, Takahashi Hiroshi, Funayama Toru, Yamazaki Masashi, Koda Masao
Department of Orthopedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan.
Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Tsukuba, Ibaraki, Japan.
Sci Rep. 2025 Jun 3;15(1):19401. doi: 10.1038/s41598-025-04361-1.
Dysphagia is a known complication following anterior cervical spine surgery, but it has also been reported after laminoplasty. We sought to determine the incidence of dysphagia following cervical laminoplasty. Prospective, multicenter, observational study of patients who underwent cervical laminoplasty or posterior lumbar spinal surgery between April 2022 and May 2024. We measured clinical characteristics, operative data, radiological parameters, and perioperative visual analog scale (VAS) for neck and throat pain. Dysphagia was assessed using the 10-item Eating Assessment Tool preoperatively and 1 week postoperatively, with new-onset dysphagia defined as a worsening of ≧ 3 points from the preoperative score. There were 79 patients in the cervical group and 89 in the lumbar group. The incidence of new-onset dysphagia was significantly higher in the cervical group (10.1%) than in the lumbar group (2.2%, P = 0.046). Within the cervical group, patients who developed new-onset dysphagia had significantly higher VAS scores for postoperative neck pain and throat pain than those without dysphagia. The incidence of new-onset dysphagia after cervical laminoplasty was significantly higher than that in the lumbar group. Patients who developed new-onset dysphagia had significantly greater postoperative neck and throat pain, suggesting that postoperative pain is associated with the development of new-onset dysphagia.
吞咽困难是颈椎前路手术后已知的并发症，但也有文献报道在椎板成形术后出现。我们试图确定颈椎椎板成形术后吞咽困难的发生率。对2022年4月至2024年5月期间接受颈椎椎板成形术或腰椎后路手术的患者进行前瞻性、多中心观察性研究。我们测量了临床特征、手术数据、放射学参数以及颈部和咽喉疼痛的围手术期视觉模拟量表（VAS）。术前和术后1周使用10项饮食评估工具评估吞咽困难情况，新发吞咽困难定义为较术前评分恶化≥3分。颈椎组有79例患者，腰椎组有89例患者。颈椎组新发吞咽困难的发生率（10.1%）显著高于腰椎组（2.2%，P = 0.046）。在颈椎组中，出现新发吞咽困难的患者术后颈部疼痛和咽喉疼痛的VAS评分显著高于未出现吞咽困难的患者。颈椎椎板成形术后新发吞咽困难的发生率显著高于腰椎组。出现新发吞咽困难的患者术后颈部和咽喉疼痛明显更严重，这表明术后疼痛与新发吞咽困难的发生有关。
