INTRODUCTION: Dysphagia is a common complication after anterior cervical discectomy and fusion (ACDF) but is not a routinely asked question in legacy patient-reported outcome measures. This study looks to see whether there are associations between dysphagia and legacy outcome measures. METHODS: We retrospectively reviewed 168 patients who underwent ACDF surgery from 2017 to 2019 at a single institution. Demographics, anthropometric data, Neck disability index (NDI), visual analog scale (VAS) pain scores, PROMIS-Health and -Mental scores, Charlson Comorbidities Index (CCI), and Eating Assessment Tool (EAT-10) were obtained for each patient preop and 1, 3, 6, and 12 months postop. Repeated measure correlations and mixed regression analyses on repeated measures were performed. RESULTS: Significant but weak correlations existed between NDI and EAT-10 at 1, 3, and 6 months postoperatively (p < 0.001, r < 0.4). Both PROMIS-Physical and -Mental scores showed weak but significant correlations with EAT-10 at 3 (p < 0.003, r = -0.26; p < 0.02, r = -0.21; respectively) and 6 months (p < 0.01, r < -.24) postoperatively. There were significant but weak correlations between VAS-pain and EAT-10 scores at 1, 3, and 6 months postoperatively (P < 0.003, R < 0.3). In all comparisons of EAT-10 with legacy outcome measures, the correlations became weaker with increased postop time. There was a positive association between EAT-10 and both CCI and BMI (p < 0.05). DISCUSSION AND CONCLUSION: Significant but weak correlations exist between dysphagia scores and legacy patient-reported outcome measures in patients undergoing ACDF. The association decreases with time; therefore, dysphagia scores should be reported separately when looking at outcomes after ACDF. Patients with higher BMI and more comorbidities are also at increased risk for dysphagia.
Zakko P, Kasir R, Chen NW, Park D. Dysphasia should be reported as a separate legacy outcome measure after anterior cervical discectomy and fusion. Virtual poster presented at: American Academy of Orthopaedic Surgeons, AAOS 2021 Annual Meeting. 2021 Sept 3; virtual.