ACDF Impact on Aerodigestive Function and Obstructive Sleep Apnea: A Scoping Review

Area of Science:

• Neurosurgery
• Sleep Medicine
• Pulmonology

Background:

• Anterior cervical discectomy and fusion (ACDF) is a common procedure for cervical spine conditions.
• Post-operative complications can include dysphagia and edema.
• The relationship between ACDF and obstructive sleep apnea (OSA) requires further investigation.

Purpose of the Study:

• To determine if ACDF increases the risk of OSA onset or exacerbation.
• To summarize outcomes for patients with ACDF and OSA.
• To identify research gaps in ACDF-OSA management.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, MEDLINE, CINAHL, Cochrane, Scopus, Web of Science, Google Scholar).
• Studies adhering to PRISMA-ScR guidelines were included, focusing on adult patients with pre- or postoperative OSA undergoing ACDF.
• Eligibility was assessed by two independent reviewers.

Main Results:

• Twelve studies reported that ACDF can lead to new-onset or worsening of pre-existing OSA.
• Patients with OSA (pre-existing or new) faced increased postoperative respiratory complications, higher healthcare utilization, and longer hospital stays.
• Potential contributing factors include pharyngeal narrowing, altered cervical alignment, edema, and hardware issues.

Conclusions:

• ACDF may contribute to OSA development or severity through structural and functional changes.
• Further prospective research is needed to evaluate interdisciplinary approaches, including OSA screening and tailored perioperative care, to improve ACDF outcomes.