A Fresh Look at Post-ACDF Dysphagia and SLP Role in Acute Management

Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure for the treatment of cervical spine pathologies, such as disc disorders and myelopathy. Patients with cervical spine disorders suffer neck pain, numbness, and in severe cases, weakness of the extremities. When patients fail conservative management, surgical treatment can be beneficial. An anterior approach to the cervical spine is preferential due to relatively low complication rates; however, dysphagia is a common and troublesome complication of this approach. The pathophysiology of dysphagia is multifactorial and while it is usually self-limiting, it causes a significant effect on patient outcomes and quality of life. In an effort to treat dysphagia, many patients are prematurely referred to speech language pathologists (SLPs) for diagnosis and management. Controversy and a lack of research exist into the timing of SLP evaluation for patients suffering dysphagia following ACDF. Utilizing current research, this author attempts to review current literature surrounding the pathophysiology of ACDF and management of dysphagia to create a SLP referral protocol for patients suffering with dysphagia following ACDF.