Introduction: This study analyzes the impact of preoperative body mass index (BMI) on the frequency, severity, and recovery of dysphagia after cervical surgeries.
Methods: A prospective multicenter quality registry of patients who underwent cervical surgery from 2016 to 2023 was retrospectively studied. The study included 1990 patients. Multivariable regression was done to evaluate the independent influence of BMI on dysphagia incidence. BMI class was analyzed with Eating Assessment Tool (EAT-10) dysphagia scores. The dataset was then split into non-obese (BMI < 30) and obese (BMI≥30) propensity matched groups with 160 patients each to analyze the effect of obesity on EAT-10 scores.
Results: Increasing BMI was correlated with developing dysphagia within 12 months after cervical surgery on univariable (p=0.037) but not multivariable analysis. Analysis by BMI class revealed highest 3-month dysphagia severity in the underweight group (underweight ( < 18.5)=4.4, normal weight (18.5-25)=2.1, overweight (25-30)=2.1, obese I (30-35)=2.0, obese II (35-40)=1.9, obese III (≥40)=2.7, p=0.018). There were no other significant correlations between BMI class and dysphagia rates or severity. After propensity matching, the non-obese group reported worsened dysphagia at 12 months than the obese group in patients without preexisting dysphagia (p=0.04). However, the non-obese group reported improved dysphagia at 12 months compared to the obese group in cases with preexisting dysphagia (p=0.03). Despite significant changes in dysphagia severity over time, there were no correlations between obesity and dysphagia rates.
Conclusion : Although patients with high BMI had greater incidence of dysphagia after cervical surgery, BMI was not an independent predictor of developing dysphagia. Underweight patients transiently experienced more severe dysphagia than other BMI classes. Non-obese patients reported worsened dysphagia severity compared to obese people in cases without preexisting dysphagia, but improved dysphagia severity in cases with preexisting dysphagia. This information can help patients and surgeons better understand how BMI impacts postoperative dysphagia after cervical spine surgery.
.jpg)
