• Eur Spine J · Nov 2020

    Observational Study

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

    • Yushi Hoshino, Ichiro Okano, Erika Chiapparelli, Stephan N Salzmann, Ortiz MillerCourtneyCSpine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA., Jennifer Shue, Andrew A Sama, Frank P Cammisa, Federico P Girardi, and Alexander P Hughes.
    • Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
    • Eur Spine J. 2020 Nov 1; 29 (11): 2745-2751.

    PurposeThe 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).MethodsThis 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.ResultsOf 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.ConclusionWe 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.

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