Changes in Swallowing, Voice, and Speech Following Cervical Spine Surgery and Factors Associated with Post-operative Dysphagia

Introduction: Dysphagia and dysphonia are common complications following anterior cervical spine surgery, and recent studies have noted these issues with posterior approaches as well. Limited research explores the acoustic changes in voice and speech following cervical spine surgery. This prospective study aims to assess changes in swallowing, voice, and speech functions after cervical spine surgery and identify factors associated with postoperative dysphagia.

Methods: Thirty participants (21 males, 9 females; mean age 55) undergoing cervical spine surgery were prospectively enrolled. Pre- and postoperative parameters were assessed. Surgical approaches included anterior, posterior, and combined methods. Swallowing assessments involved the Bazaz Dysphagia Score and the Eating Assessment Tool (EAT-10), while voice and speech functions were analyzed acoustically and perceptually. Factors associated with postoperative dysphagia, such as prior neck surgery, cerebral palsy, age, and Neck Disability Index (NDI) scores, were evaluated by comparing groups with and without dysphagia.

Results: Within one week post-surgery, 67% of participants experienced dysphagia, decreasing to 43% after one month. Those with a history of neck surgery, cerebral palsy, higher NDI scores, or who were older had an increased risk of postoperative dysphagia. Significant changes were found in voice parameters, particularly increased roughness and strain postoperatively. Swallowing tests revealed alterations in hyoid and laryngeal movement, suggesting impacts on swallowing mechanics after surgery.

Conclusion : This study underscores the prevalence of swallowing and voice complications after cervical spine surgery and identifies risk factors, including previous cervical spine surgical history, movement disorders and higher disability index. These findings suggest the importance of preoperative counseling for at-risk patients and could guide surgical approach decisions to minimize complications.