Houston Methodist. Leading Medicine

Neck FAQ

Question:

I see from your website other people writing in and asking about having trouble swallowing after neck surgery. I'm one of those people looking for some answers. Any idea why some people get this problem and others don't?

Answer:

It makes sense that patients having anterior cervical spine surgery (from the front of the neck) might experience difficulty swallowing for a few weeks after the procedure. This symptom of painful swallowing is called dysphagia. As you have discovered, some patients develop this transient (temporary) symptom and others don't. Post-operative dysphagia seems to be a fairly common problem. As many as 60 per cent of all patients having the anterior cervical discectomy and fusion (ACDF) procedure report this as an annoying and sometimes disabling symptom. Although the dysphagia usually goes away in the first three weeks after ACDF, there are cases of chronic (permanent) dysphagia. These was a recent study by surgeons from the University of Pittsburgh looking for some answers about this problem. They wondered if the process of intubation (tube down the throat) during anesthesia might be part of the problem. To find out the effect of intubation on swallowing, they compared a small number of patients who had an anterior cervical discectomy and fusion (ACDF) with a similar-sized group of patients who had a lumbar spine (low back) fusion. ACDF refers to the surgical removal of a damaged disc from between two vertebrae with fusion of those two vertebrae to each other using bone grafts, titanium cages, or other similar fixation devices. The word anterior in the name tells us the surgeon made the incision and performed the procedure from the front of the spine. The lumbar procedure was done from the back or posterior aspect of the spine. For some patients it was just a matter of removing the damaged disc while others had a disc removal and fusion. They used lumbar spine patients as the comparison group because they had spine surgery but not from the front of the neck and they were intubated during anesthesia. They found that the anterior cervical discectomy and fusion group were much more likely to experience dysphagia after surgery than the lumbar surgical group. When all the data was analyzed, it wasn't the patient's age, length of surgery (intubation), history of diabetes or rheumatoid arthritis or even body size that put patients at risk of dysphagia. This symptom was more likely to develop in women and in patients who had a history of smoking and especially those who had a history of chronic obstructive pulmonary disease (COPD). The authors concluded that post-operative dysphagia is related to the anterior cervical spine surgery and not the intubation process. The risk factors listed here may help explain why some people (but not all) develop difficulty swallowing after neck surgery. Peter A. Siska, MD, et al. Dysphagia After Anterior Cervical Spine Surgery. In Spine. August 1, 2011. Vol. 36. No. 17. Pp.1387-1391.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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