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Comparing Videofluoroscopic and Patient Reported Outcome Measures of Swallowing After ACDF Surgery.

R Brynn Jones-Rastelli1,2, Milan R Amin2, Mridula Anandhakrishnan1

  • 1Department of Communicative Sciences and Disorders, New York University, New York, USA.

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Summary

Patient-reported outcomes and videofluoroscopic swallow studies show different results after Anterior Cervical Discectomy and Fusion (ACDF) surgery. Swallowing impairments may not always align with reported dysphagia symptoms post-ACDF.

Keywords:
ACDFdysphagiaswallowing

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Speech-Language Pathology

Background:

  • Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure.
  • Postoperative dysphagia and swallowing difficulties are potential complications following ACDF.
  • Assessing swallowing function and patient experience after ACDF is crucial for recovery.

Purpose of the Study:

  • To compare videofluoroscopic swallow study (VFSS) findings with patient-reported outcome tools (PROs) after ACDF.
  • To evaluate the impact of ACDF on swallowing function and dysphagia symptoms.
  • To analyze the alignment between objective swallowing measures and subjective patient reports.

Main Methods:

  • Secondary analysis of prospectively collected data from 21 ACDF patients.
  • VFSS data included the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) and MBSImP scores.
  • PROs included the Bazaz Dysphagia Scale, EAT-10, SWAL-QoL, and HSS-DDI, collected pre- and post-operatively.

Main Results:

  • ACDF surgery significantly worsened swallowing outcomes at six weeks post-surgery.
  • Patient-reported outcome tools indicated higher postoperative prevalence and incidence of swallowing issues compared to DIGEST.
  • Clinically meaningful changes were comparable across PROs and DIGEST, but individual case correlations were inconsistent.

Conclusions:

  • A discrepancy exists between objective physical swallowing function and subjective patient-reported dysphagia symptoms after ACDF.
  • The presence or absence of dysphagia symptoms may not directly correlate with observed physical impairments post-ACDF.
  • This highlights the importance of considering both objective and subjective measures in ACDF recovery assessment.