| Objective:To investigate the relationship between cervical curvature and dysphagia after anterior cervical discectomy and fusion.Methods:209 patients who underwent ACDF procedure were reviewed in the present study between December 2017 and December 2019.According to Bazaz dysphagia scale,the patients were divided into two groups: postoperative dysphagia group and non postoperative dysphagia group.The influence of preoperative and postoperative C2-C7 cobb angle(d C2-C7 cobb angle)and O-C2 cobb angle(d O-C2 cobb angle)on the incidence of postoperative dysphagia was investigated.Other related factors that may lead to postoperative dysphagia,including gender,age,BMI,smoking,drinking,diabetes,hypertension,operation segment,intraoperative blood loss and operation time,were also included in the analysis to ensure the accuracy of the research results.Results:209 patients were enrolled in this study,including 50 cases of postoperative dysphagia group and 159 cases of non postoperative dysphagia group.The incidence rate of postoperative dysphagia was 23.9%.There was no difference in gender,age,BMI,smoking history,drinking history,diabetes history,hypertension history,operation segment and intraoperative blood loss between the two groups(P > 0.05).The operation time of dysphagia group was(98.63 ± 39.81min),and that of non dysphagia group was(92.22 ± 32.07min),the difference was statistically significant(P < 0.001).In dysphagia group,preoperative O-C2 cobb angle was(13.59 ± 6.23)°,postoperative O-C2 cobb angle was(13.77 ± 5.56)°,d O-C2 cobb angle was(0.45 ±4.97)°;preoperative C2-C7 Cobb angle was(12.18 ± 7.10)°,postoperative C2-C7 Cobb angle was(17.15 ± 8.33)°,d C2-C7 Cobb angle was(4.97 ± 7.62)°.In non dysphagia group,preoperative O-C2 cobb angle was(13.05 ± 5.22)°,postoperative O-C2 cobb angle was(12.93 ± 4.41)°,d O-C2 cobb angle was(1.25 ± 5.52)°;preoperative C2-C7 Cobb angle was(13.07 ± 7.74)°,postoperative C2-C7 Cobb angle was(14.53 ± 8.89)°,d C2-C7 Cobb angle was(1.47 ± 6.85)°.To sum up,the difference of d C2-C7 Cobb angle between the two groups was statistically significant(P< 0.05).Logistic regression analysis showed that operation time(OR = 1.017,P < 0.001),d C2-C7 Cobb angle(OR= 1.039,P = 0.042)were related to the incidence of dysphagia after ACDF.Conclusion:In conclusion,the change of cervical curvature after anterior cervical fusion has a certain impact on the incidence of postoperative dysphagia.The increase of operation time and d C2-C7 Cobb angle were related to the increase of dysphagia.Although postoperative dysphagia is caused by multiple factors,gender,age,BMI,smoking,drinking,diabetes,hypertension,surgical segment,intraoperative blood loss,d O-C2 cobb angle are not risk factors of postoperative dysphagia in this study. |
