Outcomes of Open Osteophytectomy in Dysphagia Related to Cervical Osteophytes: A Systematic Review

This study investigates the efficacy of open osteophytectomy in patients with dysphagia associated with cervical osteophytes, stratified by C-spine level and presence of diffuse idiopathic skeletal hyperostosis (DISH).

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We conducted a systematic review of published literature pertaining to osteophyte-related dysphagia. Patients with objective measurements of dysphagia severity who underwent an open surgical approach for osteophytectomy were included. Demographics, symptomatology, and patient outcomes were analyzed.

A total of 44 articles with 214 cases (mean age = 67, 85% male) were included. Outcomes after osteophytectomy were analyzed in DISH vs non-DISH groups, as well as stratified by demographics and cervical levels affected. Patients with osteophytes at or above C4 were more likely to demonstrate pre-operative aspiration (P = .018). Short- and long-term outcomes among patients with DISH and non-DISH osteophytes were similar (P = .269 and .476). Outcomes among patients with osteophytes at or above C4, at or below C4, and diffuse presentations were also similar. Among all cases, 84% of patients experienced significant short-term initial improvement in their dysphagia. At long-term follow-up, 82% of patients had continued significant improvement in their dysphagia outcome.

Open surgical approaches for osteophytectomy demonstrate good short- and long-term efficacy. Patients with osteophytes at or above C4 were more likely to aspirate pre-operatively, but osteophyte level, age, sex, and presence of DISH did not impact likelihood of operative success.