Hyoid position as a novel predictive marker for postoperative dysphagia and dysphonia after anterior cervical discectomy and fusion.,European Spine Journal

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Hyoid position as a novel predictive marker for postoperative dysphagia and dysphonia after anterior cervical discectomy and fusion.
European Spine Journal ( IF 2.8 ) Pub Date : 2020-06-07 , DOI: 10.1007/s00586-020-06484-7
Yushi Hoshino _{1,

2,

3} , Ichiro Okano ₁ , Erika Chiapparelli ₁ , Stephan N Salzmann ₁ , Courtney Ortiz Miller ₁ , Jennifer Shue ₁ , Andrew A Sama ₁ , Frank P Cammisa ₁ , Federico P Girardi ₁ , Alexander P Hughes ₁

Affiliation

Purpose

The purpose of this study is to investigate the predictive value of the hyoid horizontal positional change on the severity of dysphagia and dysphonia (PDD) after anterior cervical discectomy and fusion (ACDF) comparing pre-vertebral soft-tissue thickness (PVST).

Methods

This is a retrospective observational study with prospectively collected data at a single academic institution. ACDF patients between 2015 to 2018 who had complete self-reported PDD surveys and pre- and postoperative lateral cervical radiographs were included in the analysis. PDD was assessed utilizing the Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI). The hyoid-vertebral distance (HVD) and PVST (the averages of C2 to C7 levels (PVSTC2–7) and all operating levels (PVSTOP)) were assessed preoperatively and upon discharge. The associations among postoperative changes of HVD, PVSTs, and the 4-week HSS-DDI score were evaluated.

Results

Of the 268 patients with a HSS-DDI score assessment, 209 patients had complete data. In univariate analyses, HVD and PVSTC2–7 changes demonstrated significant correlations with HSS-DDI, whereas PVSTOP showed no significant association. After adjusting with sex and operating level, the changes in HVD (p = 0.019) and PVSTC2–7 (p = 0.009) showed significant associations with the HSS-DDI score and PVSTOP showed no significant association. PVSTC2-7 could not be evaluated in 12% of patients due to measurement difficulties of PVST at lower levels.

Conclusion

We introduce a novel potential predictive marker for PDD after ACDF. Our results suggest that HVD can be utilized for the risk assessment of PDD, especially in PVST unmeasurable cases, which accounts for over 10% of ACDF patients.

中文翻译：

舌骨位置作为颈椎前路椎间盘切除术和融合术后术后吞咽困难和声躁的新型预测标志。

目的

这项研究的目的是调查比较颈椎前路椎间盘切除术和融合术（ACDF）后舌骨水平位置改变对吞咽困难和言语障碍（PDD）的预测价值，比较椎体前软组织厚度（PVST）。

方法

这是一项回顾性观察性研究，其前瞻性地收集了单个学术机构的数据。分析包括2015年至2018年之间完成自我报告的PDD调查以及术前和术后颈椎X线片的ACDF患者。利用特殊外科吞咽困难和言语障碍清单（HSS-DDI）对PDD进行了评估。术前和出院时评估了舌骨距（HVD）和PVST（C2至C7水平的平均值（PVSTC2-7）和所有操作水平（PVSTOP）的平均值）。评估术后HVD，PVSTs和4周HSS-DDI评分之间的关联。

结果

在268位接受HSS-DDI评分评估的患者中，有209位患者拥有完整的数据。在单变量分析中，HVD和PVSTC2-7的变化显示与HSS-DDI有显着的相关性，而PVSTOP没有显示显着的相关性。在根据性别和手术水平进行调整后，HVD（p = 0.019）和PVSTC2–7（p = 0.009）的变化与HSS-DDI评分呈显着相关，而PVSTOP没有显着相关。由于在较低水平下PVST的测量困难，无法在12％的患者中评估PVSTC2-7。