Journal article
Recurrent Laryngeal Nerve Palsy Is More Frequent After Secondary than After Primary Anterior Cervical Discectomy and Fusion: Insights from a Registry of 525 Patients.
- Staartjes VE Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands; Faculty of Medicine, University of Zurich, Zurich, Switzerland. Electronic address: victor.staartjes@gmail.com.
- de Wispelaere MP Department of Clinical Informatics, Bergman Clinics, Naarden, The Netherlands.
- Schröder ML Department of Neurosurgery, Bergman Clinics, Amsterdam, The Netherlands.
- 2018-06-05
Published in:
- World neurosurgery. - 2018
Cervical
Complication
Discectomy
Dysphagia
Fusion
Recurrent laryngeal nerve
Reoperation
Adult
Diskectomy
Female
Humans
Male
Middle Aged
Outcome Assessment, Health Care
Postoperative Complications
Recurrent Laryngeal Nerve Injuries
Registries
Retrospective Studies
Spinal Cord Injuries
Spinal Fusion
Statistics, Nonparametric
Time Factors
Vocal Cord Paralysis
English
BACKGROUND
Recurrent laryngeal nerve (RLN) palsy is a common complication after anterior cervical discectomy and fusion (ACDF) and usually manifests with dysphagia, hoarseness, and respiratory difficulties. Next to proven risk factors, such as age and multilevel procedures, RLN palsy has been speculated to occur more frequently after secondary ACDF procedures.
METHODS
We analyzed a prospective registry of all consecutive patients undergoing zero-profile ACDF for disc herniation, myelopathy, or stenosis. RLN palsy was defined as persistent patient self-reported dysphagia, hoarseness, or respiratory problems without other identifiable causes. RLN palsy was assessed at scheduled 6-week telephone interviews.
RESULTS
Among 525 included patients, 511 primary and 40 secondary ACDF procedures were performed. Hoarseness was present in 12 (2.2%) cases, whereas dysphagia and respiratory difficulties both occurred in 3 (0.5%) cases. Overall incidence of RLN palsy was 2% after primary procedures and 8% after secondary procedures (P = 0.017). These rates are in line with the peer-reviewed literature, and the difference remained significant after controlling for confounders in a multivariate model (P = 0.033). Other reported risk factors, such as age, sex, surgical time, and multilevel procedures, had no relevant effect (P > 0.05).
CONCLUSIONS
Based on our data and other published series in the literature, RLN palsy may occur more frequently after secondary ACDF procedures with a clinically relevant effect size. There is a striking lack of uniformity in methods and reporting in research on RLN injury.
Recurrent laryngeal nerve (RLN) palsy is a common complication after anterior cervical discectomy and fusion (ACDF) and usually manifests with dysphagia, hoarseness, and respiratory difficulties. Next to proven risk factors, such as age and multilevel procedures, RLN palsy has been speculated to occur more frequently after secondary ACDF procedures.
METHODS
We analyzed a prospective registry of all consecutive patients undergoing zero-profile ACDF for disc herniation, myelopathy, or stenosis. RLN palsy was defined as persistent patient self-reported dysphagia, hoarseness, or respiratory problems without other identifiable causes. RLN palsy was assessed at scheduled 6-week telephone interviews.
RESULTS
Among 525 included patients, 511 primary and 40 secondary ACDF procedures were performed. Hoarseness was present in 12 (2.2%) cases, whereas dysphagia and respiratory difficulties both occurred in 3 (0.5%) cases. Overall incidence of RLN palsy was 2% after primary procedures and 8% after secondary procedures (P = 0.017). These rates are in line with the peer-reviewed literature, and the difference remained significant after controlling for confounders in a multivariate model (P = 0.033). Other reported risk factors, such as age, sex, surgical time, and multilevel procedures, had no relevant effect (P > 0.05).
CONCLUSIONS
Based on our data and other published series in the literature, RLN palsy may occur more frequently after secondary ACDF procedures with a clinically relevant effect size. There is a striking lack of uniformity in methods and reporting in research on RLN injury.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.wneu.2018.05.162
- PMID 29864565
- Persistent URL
- https://folia.unifr.ch/global/documents/11853
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