Journal article
Outcomes and complications of surgical treatment of anterior osteophytes causing dysphagia: Single center experience
Clinical neurology and neurosurgery, Vol.207, pp.106814-106814
08/2021
DOI: 10.1016/j.clineuro.2021.106814
PMID: 34303287
Abstract
Retrospective case series.
To better understand the functional swallow outcomes, cervical balance, and surgical complications, we examined patients with anterior osteophytes and dysphagia who were treated operatively.
Anterior osteophytes from diffuse idiopathic skeletal hyperostosis (DISH) or degenerative etiology of the cervical spine can cause dysphagia from mechanical compression of the esophagus. Osteophytectomy is generally accepted as a safe surgical treatment, but the risk of instability is unclear. The potential for associated complications must be considered.
Patients who had anterior osteophytes and dysphagia from 2005 to 2020 were reviewed retrospectively. Demographics, radiographic parameters, functional swallow outcome, and complications were examined.
There were 15 patients identified treated surgically. Increased osteophyte height positively correlated with severity of dysphagia with Pearson coefficient of 0.53 (p = 0.042). Functional Outcome Swallowing Scale (FOSS) scores improved after surgical treatment from median of 2 to 0 (p = 0.002). C2–7 SVA did increase by 8 mm (p = 0.007) but was generally well tolerated. There was a 27% complication rate including a case of C5 lateral mass fracture with central cord syndrome after a fall 4 days following osteophytectomy. There was one patient who was preoperatively dependent on gastrostomy tube who required a tracheostomy and had continued reliance on the gastrostomy tube.
Surgical treatment of anterior osteophytes causing dysphagia with osteophytectomy can lead to overall improved FOSS scores for most patients. However, a high preoperative FOSS score may be a prognostic indicator of poor postoperative functional swallow outcome. It is important to consider the potential for instability when osteophytectomy is performed at 3 or more spinal segments.
•Osteophytectomy showed improvement in swallow function•Asymptomatic increase of 8 mm in C2-7 SVA occurred following osteophytectomy.•There exists a potential for instability to develop after extensive osteophytectomy.
Details
- Title: Subtitle
- Outcomes and complications of surgical treatment of anterior osteophytes causing dysphagia: Single center experience
- Creators
- Brian J. Park - University of IowaColin J. Gold - University of Iowa Hospitals and ClinicsAnthony Piscopo - University of IowaLaura Schwickerath - University of Iowa Hospitals and ClinicsGirish Bathla - University of IowaLee-Onn Chieng - University of Iowa Hospitals and ClinicsSatoshi Yamaguchi - University of IowaPatrick W. Hitchon - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.207, pp.106814-106814
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.clineuro.2021.106814
- PMID
- 34303287
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Language
- English
- Date published
- 08/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Neurosurgery
- Record Identifier
- 9984303911802771
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