Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial
Objective To determine the effect of anterior plating on postoperative dysphagia (POD) among adult patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and determine the potential role of demographic and clinical characteristics in the development of P...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2020-03-01
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| Series: | Neurospine |
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| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-1938446-223.pdf |
| _version_ | 1797335402149838848 |
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| author | Tom J. O’Donohoe Lisa Mililli Alison Magee Christopher Thien Yi Yuen Wang |
| author_facet | Tom J. O’Donohoe Lisa Mililli Alison Magee Christopher Thien Yi Yuen Wang |
| author_sort | Tom J. O’Donohoe |
| collection | DOAJ |
| description | Objective To determine the effect of anterior plating on postoperative dysphagia (POD) among adult patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and determine the potential role of demographic and clinical characteristics in the development of POD. Methods Consecutive adults undergoing an elective, single-level, ACDF were randomly assigned to receive a stand-alone CoRoent Cage or a CoRoent Cage with a Helix, or Helix-Mini plate. Patients with a history of cervical spine surgery were excluded. M. D. Anderson Dysphagia Inventory and Bazaz questionnaires were completed at regular intervals for 12 months postoperatively. Results Twenty-five patients were recruited over a 2-year period, with 8 allocated to receive a stand-alone cage, 5 to receive a cage and Helix Mini plate, and 12 to receive a cage and Helix plate. The POD rate was 68% at 48 hours, before falling to 16% at 6 and 12 months. A longer retraction time was observed in the Helix plate group compared to the stand-alone cage group (7.88; 95% confidence interval, 0.12–15.63; p = 0.046), although there was no difference in the incidence or severity of dysphagia between cohorts at any timepoint. With the exception of body mass index, there was no difference in patients with and without dysphagia, and each of the interventions was equally efficacious with respect to clinical and radiological endpoints. Conclusion Dysphagia is a common consequence of ACDF and, while the placement of a large plate results in longer retraction time, it was not associated with higher rates of dysphagia. Further research is required to identify both patient-specific and surgical contributors to this complication. |
| first_indexed | 2024-03-08T08:37:36Z |
| format | Article |
| id | doaj.art-b9526df3cc144348ad2cbc4962a0d075 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:37:36Z |
| publishDate | 2020-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-b9526df3cc144348ad2cbc4962a0d0752024-02-02T00:40:31ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912020-03-0117117418310.14245/ns.1938446.223980Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized TrialTom J. O’Donohoe0Lisa Mililli1Alison Magee2Christopher Thien3Yi Yuen Wang4 Department of Neurosurgery, St. Vincent’s Hospital, Fitzroy, VIC, Australia Keyhole Neurosurgery, Fitzroy, VIC, Australia Keyhole Neurosurgery, Fitzroy, VIC, Australia Department of Neurosurgery, St. Vincent’s Hospital, Fitzroy, VIC, Australia Department of Neurosurgery, St. Vincent’s Hospital, Fitzroy, VIC, AustraliaObjective To determine the effect of anterior plating on postoperative dysphagia (POD) among adult patients undergoing elective anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and determine the potential role of demographic and clinical characteristics in the development of POD. Methods Consecutive adults undergoing an elective, single-level, ACDF were randomly assigned to receive a stand-alone CoRoent Cage or a CoRoent Cage with a Helix, or Helix-Mini plate. Patients with a history of cervical spine surgery were excluded. M. D. Anderson Dysphagia Inventory and Bazaz questionnaires were completed at regular intervals for 12 months postoperatively. Results Twenty-five patients were recruited over a 2-year period, with 8 allocated to receive a stand-alone cage, 5 to receive a cage and Helix Mini plate, and 12 to receive a cage and Helix plate. The POD rate was 68% at 48 hours, before falling to 16% at 6 and 12 months. A longer retraction time was observed in the Helix plate group compared to the stand-alone cage group (7.88; 95% confidence interval, 0.12–15.63; p = 0.046), although there was no difference in the incidence or severity of dysphagia between cohorts at any timepoint. With the exception of body mass index, there was no difference in patients with and without dysphagia, and each of the interventions was equally efficacious with respect to clinical and radiological endpoints. Conclusion Dysphagia is a common consequence of ACDF and, while the placement of a large plate results in longer retraction time, it was not associated with higher rates of dysphagia. Further research is required to identify both patient-specific and surgical contributors to this complication.http://www.e-neurospine.org/upload/pdf/ns-1938446-223.pdfcervical spinecervical spondylosisanterior cervical discectomy and fusionanterior plate augmentationdysphagia |
| spellingShingle | Tom J. O’Donohoe Lisa Mililli Alison Magee Christopher Thien Yi Yuen Wang Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial Neurospine cervical spine cervical spondylosis anterior cervical discectomy and fusion anterior plate augmentation dysphagia |
| title | Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial |
| title_full | Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial |
| title_fullStr | Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial |
| title_full_unstemmed | Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial |
| title_short | Effect of the Presence and Type of Plate Augmentation on Postoperative Dysphagia Among Adult Patients Undergoing Elective Anterior Cervical Discectomy and Fusion for Spondylosis: A Randomized Trial |
| title_sort | effect of the presence and type of plate augmentation on postoperative dysphagia among adult patients undergoing elective anterior cervical discectomy and fusion for spondylosis a randomized trial |
| topic | cervical spine cervical spondylosis anterior cervical discectomy and fusion anterior plate augmentation dysphagia |
| url | http://www.e-neurospine.org/upload/pdf/ns-1938446-223.pdf |
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