Dysphagia prevention in anterior cervical discectomy surgery.

Dysphagia prevention in anterior cervical discectomy surgery.

World Neurosurg. 2019 Feb 19;:

Authors: Grasso G, Leone L, Torregrossa F

Abstract
BACKGROUND: Dysphagia is a common complication after anterior cervical discectomy surgery (ACDS). Recent studies have shown that reducing the endotracheal tube cuff pressure (ETCP), local irrigation with methylprednisolone, and minimizing the pharynx/esophagus retraction can decrease the incidence of post-operative dysphagia following ACDS. This is the first study assessing the efficacy of all these three measures simultaneously.
METHODS: This prospective study included 35 patients (Group 1) who underwent ACDS with the adoption of all the three preventive measures. Group 1 has been compared with a homogenous group of 35 patients who underwent regularly ACDS (Group 2). Postoperative dysphagia and odynophagia have been evaluated at 2 days, 7 days, 14 days and hence at 3, 6, and 12 months. Age, gender, body mass index (BMI), operating time, blood loss, and preoperative JOA score were collected.
RESULTS: Postoperative dysphagia was observed in 3 cases (8.6%) in Group 1 and 15 cases (42.9%) in Group 2 (P<0.05). Three patients of group 1 had transient dysphagia with complete resolution at the last follow-up while 6 patients of Group 2 (17.1%) had permanent dysphagia (P<0.05). Finally, 9 patients (25.7%) of group 2 presented with transient dysphagia with complete resolution at the last follow-up. The mean VAS for odynophagia was significantly lower in group 1 as compared with group 2 (P<0.05).
CONCLUSIONS: Postoperative dysphagia occurs frequently after ACDS. Here we have shown that the adoption of preventive measures during surgery can reduce the rate of dysphagia. Future evaluations will be mandatory to be investigated in a large clinical trial.

PMID: 30794969 [PubMed - as supplied by publisher]

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