Post-operative dysphagia in patients undergoing a four level anterior cervical discectomy and fusion (ACDF)

Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure for cervical spine pathologies, with excellent arthrodesis and symptom resolution. Post-operative dysphagia is a significant concern for patients undergoing this procedure because it can significantly affect their quality of life. Studies have shown that the incidence of post-operative dysphagia increases with an increase in the number of levels performed. A retrospective chart review was performed by interrogating our procedure log system and the key words "anterior cervical discectomy and fusion" was inserted in to the search bar. All patients with a four level ACDF were selected. Chart review was performed for their speech evaluation immediate after surgery and three months post operatively. A total of 28 patients were identified for the study. Speech evaluation records were available for 21 of the 28 patients. Two of the patients had posterior instrumentation and were eliminated. There were 11 females and 8 males, average age was 62 (range 47-73), and all the patients had a C3-C7 ACDF. 2 out of the 19 (11%) patients had dysphagia diagnosed via barium swallow evaluation immediately after surgery, which persisted for 3 months. Both patients diagnosed with dysphagia were females. The Two patients were 72 and 73 years old. The incidence of post-operative dysphagia in patients undergoing 4 levels ACDF at our institution was found to be lower than the current literature quotes. Age and gender were more predictive of developing dysphagia in this study.