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World Neurosurg ; 95: 148-155, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27506403

RESUMO

OBJECTIVE: To determine any differences in self-reported dysphagia in patients treated with single-level anterior cervical decompression with different zero-profile implants (arthroplasty vs. arthrodesis) and identify risk factors for postoperative dysphagia. METHODS: A total of 112 patients with 1-level cervical degenerative disc disease were included in the prospective study. The dysphagia conditions and radiologic results were assessed using Bazar dysphagia scoring system, the Swallowing Quality of Life scores, cervical alignment (CA), segmental angle, and prevertebral soft tissues swelling (PSTS). All these parameters were compared before and after surgery in the respective group, which were also compared between the 2 groups. Correlations between the confounding factors and postoperative dysphagia were analyzed. RESULTS: No significant differences existed in preoperative or initially postoperative dysphagia rate and scores between the 2 groups (P > 0.05). However, the dysphagia rate and scores of cervical disc arthroplasty was better than those of fusion at postoperative day 7. Heavy smoker, PSTS change (≥5 mm), or CA change (≥5 degrees) was prone to have postoperative dysphagia. CONCLUSIONS: Postoperative dysphagia remains a common incidence, despite advances in instrumentation technologies. However, cervical disc arthroplasty is superior to anterior cervical discectomy and fusion in ameliorating the symptom of dysphagia in the early postoperative term. Heavy smoker, PSTS change (≥5 mm), and CA change (≥5 degrees) were important predictors of postoperative dysphagia.


Assuntos
Vértebras Cervicais/cirurgia , Descompressão Cirúrgica , Transtornos de Deglutição/epidemiologia , Discotomia , Degeneração do Disco Intervertebral/cirurgia , Complicações Pós-Operatórias/epidemiologia , Fusão Vertebral , Substituição Total de Disco , Adulto , Artroplastia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Próteses e Implantes , Fatores de Risco
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