Recovery rates of postoperative dysphagia following cervical spine surgery

This study examines the recovery rates of patients who experience postoperative dysphagia within 1 month following cervical spine surgery.

Data from a prospectively maintained multi-institutional quality registry were retrospectively analyzed. Eating Assessment Tool-10 (EAT-10) questionnaire scores were collected at baseline and 1, 3, and 12 months postoperatively, with total scores ≥ 3 indicating dysphagia. Patients were grouped by whether they reported baseline dysphagia to assess the impact of baseline dysphagia on recovery. Recovery was defined as resolution of postoperative dysphagia and not reporting the condition at any follow-up time point. Patients were excluded from the recovery model if they did not report dysphagia within 1 month of surgery. Recovery to baseline was defined as reporting a postoperative EAT-10 score equal to or less than the baseline score at subsequent time points. Patients were excluded from the recovery-to-baseline model if they did not report EAT-10 scores within 1 month of surgery that were worse than their baseline score. Survival curves were generated for both models.

Of the 2003 patients in the registry, 627 met inclusion criteria for the recovery curve and 714 for the recovery-to-baseline curve. Of the patients without baseline dysphagia, 498 developed new postoperative dysphagia within 1 month, with cumulative recovery probabilities of 39.5% by 3 months and 59.1% by 12 months after cervical spine surgery. Furthermore, of the patients without baseline dysphagia, 73.5% (175/238) who reported no dysphagia at 3 months and 32.5% (68/209) who reported no dysphagia at 12 months experienced long-term recovery. Eighty patients with baseline dysphagia reported worse EAT-10 scores within 1 month, with cumulative probabilities of improvement to baseline or below of 37.7% by 3 months and 54.1% by 12 months. Patients with baseline dysphagia were significantly less likely to recover than patients without baseline dysphagia (hazard ratio [HR] 0.37, 95% CI 0.26-0.53; p < 0.001) but significantly more likely to recover to baseline (HR 1.45, 95% CI 1.05-2.00; p = 0.025).

Patients who develop postoperative dysphagia within 1 month of cervical spine surgery generally see symptomatic improvement over time. This analysis may aid in clinical decision-making when informing patients about the risk of developing postoperative dysphagia and the recovery rate of this surgical complication.