Swallowing performance following anterior cervical spine surgery

Abstract

The aim of this study was to assess the incidence and severity of dysphagia following anterior cervical spine surgery for cervical spondylosis. One-hundred patients were contacted 12-22 months following cervical spine surgery. Those reporting persistent swallowing impairment were invited to attend for further investigation. Of 73 respondents, 33 (45%) experienced postoperative dysphagia. This persisted for longer than 6 months in nine (12% of respondents). Of five subjects attending for investigation, none had a definite radiological abnormality. In contrast, manometry suggested hyperactivity of the pharyngo-oesophageal segment in these patients, although with normal co-ordination. Surgeons should warn of the risk of transient dysphagia in 45% of patients postoperatively and of its persistence in around 10%. Radiological examination may be normal and manometry is the investigation of choice. Persistent, severe dysphagia may be ameliorated by cricopharyngeal myotomy or pharyngeal dilatation.