Impact of Age and Associated Factors on Postoperative Dysphagia Following Cervical Spine Surgery

Introduction: This study investigates the relationship between age and the incidence of postoperative dysphagia following cervical spine surgery.

Methods: A prospectively collected multi-institutional quality registry was retrospectively reviewed. Patients undergoing cervical surgery were categorized by age, and correlations with preoperative and postoperative Eating Assessment Tool-10 (EAT-10) dysphagia questionnaire scores were assessed. Mixed-effects logistic regressions were performed to examine the impact of age on postoperative dysphagia.

Results: Of the 2,003 patients, 822 (41%) were at least 60 years old. Patients over 60 have no significant difference in incidence of dysphagia at 1 month (57% vs. 55%, p=0.4), 3 months (31% vs. 27%, p=0.2), or 12 months (28% vs. 24%, p=0.2) after surgery. Multivariable analysis indicated that age over 60 was not a significant predictor of postoperative dysphagia at 1 month (OR=0.98, p=0.9), 3 months (OR=0.81, p=0.2), or 12 months (OR=0.80, p=0.2). Patients with no baseline dysphagia who are over 60 (697 out of 822) had a significantly higher incidence of new postoperative dysphagia at 3 months (27% vs. 21%, p=0.008) and 12 months (23% vs. 18%, p=0.025) but not at 1 month (54% vs. 50%, p=0.2). Multivariable analysis indicated that age over 60 was not a significant predictor of new postoperative dysphagia at 1 month (OR=1.06, p=0.7), 3 months (OR=0.99, p>0.9), or 12 months (OR=0.92, p=0.7).

Conclusion : While multivariable analysis suggests age alone may not be a significant predictor of new postoperative dysphagia, there was an increased incidence of dysphagia at 3 and 12 months in patients over age 60 without baseline dysphagia. However, these finding may be confounded by a higher prevalence of complex surgical procedures and comorbidities. While age is commonly viewed as a risk factor for postoperative complications, our results indicate that age is not a significant contributor to dysphagia risk following cervical spine surgery, which can inform clinical decision-making.