Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: A prospective, objective preoperative and postoperative assessment

Anthony Frempong-Boadu, John K. Houten, Brett Osborn, Jose Opulencia, Latimer Kells, Deborah D. Guida, Peter D. Le Roux

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

Swallowing difficulties and dysphonia may occur in patients undergoing anterior cervical discectomy and fusion. The etiology and incidence of these abnormalities, however, are not well defined. In view of this, we performed a prospective, objective analysis of swallowing function and vocal cord approximation in patients undergoing anterior cervical discectomy and fusion. Twenty-three consecutive patients (22 male and one female, mean age 59 years) undergoing anterior cervical discectomy and fusion had standardized modified barium swallow study and videolaryngoendoscopy performed preoperatively and again at 1 week and 1 month postoperatively. Eleven patients (48%) had radiographic evidence of preoperative swallowing abnormalities. The majority of these patients had myelopathic rather than radicular findings (p = 0.03). None, however, had symptoms of swallowing dysfunction. Among these patients, one had worse function postoperatively, three had improvement, and function remained unchanged in seven. The preoperative swallowing assessment was normal in 12 patients (52%). Postoperative radiographic swallowing abnormalities were demonstrated in eight of these patients (67%). Preoperative vocal cord movement was normal in all patients. Postoperatively, vocal cord paresis was detected in two patients. The paresis was transient in one and permanent in the other. Age, previous medical history, operation duration, and spinal level decompressed were not significantly associated with the incidence of swallowing dysfunction. There was, however, a tendency for patients undergoing multilevel surgery to demonstrate an increased incidence of swallowing abnormalities on postoperative radiographic studies. In addition, soft tissue swelling was more frequent in patients whose swallowing function was worse postoperatively (p = 0.007). Postoperative voice and swallowing dysfunction are common complications of anterior cervical discectomy and fusion, although in the majority of patients these abnormalities are not symptomatic. Patients undergoing multilevel procedures are at an increased risk for these complications, in part because of soft tissue swelling in the neck.

Original languageEnglish (US)
Pages (from-to)362-368
Number of pages7
JournalJournal of Spinal Disorders and Techniques
Volume15
Issue number5
StatePublished - Oct 2002
Externally publishedYes

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Diskectomy
Deglutition
Vocal Cords
Incidence
Dysphonia
Vocal Cord Paralysis
Paresis
Barium

Keywords

  • Cervical spine surgery
  • Complications
  • Dysphagia
  • Prospective
  • Vocal cord paralysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion : A prospective, objective preoperative and postoperative assessment. / Frempong-Boadu, Anthony; Houten, John K.; Osborn, Brett; Opulencia, Jose; Kells, Latimer; Guida, Deborah D.; Le Roux, Peter D.

In: Journal of Spinal Disorders and Techniques, Vol. 15, No. 5, 10.2002, p. 362-368.

Research output: Contribution to journalArticle

Frempong-Boadu, Anthony ; Houten, John K. ; Osborn, Brett ; Opulencia, Jose ; Kells, Latimer ; Guida, Deborah D. ; Le Roux, Peter D. / Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion : A prospective, objective preoperative and postoperative assessment. In: Journal of Spinal Disorders and Techniques. 2002 ; Vol. 15, No. 5. pp. 362-368.
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