Serious dysphagia following anterior cervical discectomy and fusion: long-term incidence in a national cohort.

Journal of Neurosurgical Sciences
Wu-Fu ChungSu-Shun Lo

Abstract

Although dysphagia is often self-limiting after anterior cervical discectomy and fusion (ACDF), its incidence, risks, and long-term outcomes remain unclear. The present study aimed to analyze dysphagia up to 5 years post-ACDF using a nation-scaled cohort. Incidences of permanent dysphagia requiring nasogastric-tube feeding after ACDF were analyzed using three million-sample cohorts derived from the National Health Insurance Research Database of Taiwan. All identified subjects were stratified into four groups (40's, 50's, 60's, and >70) according to their age at operation, and were subsequently followed up for 5 years. The risks of dysphagia were compared between the groups using Kaplan-Meier analysis and Cox regression hazard ratio model. A total of 2723 patients (>40 years old) who received first-time ACDF surgery were identified from a cohort of three million and followed up for a maximum of 5 years post-operation. The 5-year incidence rates of persistent dysphagia (requiring use of a nasogastric tube) were 6.1, 4.0, 12.0, and 22.8 per 1000 person-years for each age group (40's, 50's, 60's, and 70+ years old, respectively). The overall incidence rate of dysphagia after ACDF was 18.4, 10.9, and 8.9 per 1000 person-years at 3 m...Continue Reading

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