Interested medical professionals can read the full paper, as published in Spine, here.
Prospective radiographic analysis with clinical correlates.
The purpose of this study was to determine whether patients with cervical plates protruding off the vertebral body more prominently than pre-existing osteophytes had higher rates of dysphagia, suggesting a mechanical role.
Summary of Background Data
Plate prominence due to mechanical causes has been implicated as a cause of dysphagia after anterior cervical fusion. This study therefore assessed the potential of plate prominence as a cause of dysphagia after anterior cervical fusion and the predictive role of preoperative osteophyte heights.
Osteophyte heights measured on the preoperative radiographs of 63 patients, 41 males and 23 females with mean age 54 years (range, 31 to 75), who underwent anterior fusion (2 mm SYNTHES CSLP plates). After surgery, the distance of the plate from the vertebral body was measured and compared with preoperative osteophyte heights. Group I contained 30 patients who had cervical plates protrude less than or equal to the height of the tallest preoperative osteophyte. Group II contained 34 patients who had plates protrude greater than the height of the tallest preoperative osteophyte.
No patients had preoperative dysphagia. Five of 30 Group I patients had dysphagia (>1 month). Six of 34 group II patients had dysphagia. There was no difference between groups I and II in rate of dysphagia (beta > 0.90). Plates at C3 and shorter cervical constructs trended higher rates of dysphagia.
Long-term postoperative dysphagia in Group I patients and the lack of a difference in rates of dysphagia between group I and group II, made it improbable plate thickness of 2 mm or prominence between 3 and 7 mm consistently played roles in dysphagia. Preoperative osteophyte height did not predict which patients developed postoperative dysphagia. Plates at the C3 and shorter constructs trended to have higher rates of dysphagia.
About Author Dr. Kingsley R. Chin
Dr. Kingsley R. Chin is a board-certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology experience. He sees a niche opportunity where medicine, business and information technology meet and is uniquely experienced at the intersection of these three professions. He currently serves as Professor of Clinical and Biomedical Sciences at the Charles E. Schmidt School of Medicine at Florida Atlantic University and Professor of Clinical Orthopaedic Surgery at the Herbert Wertheim College of Medicine at Florida International University and has experience as Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School and Visiting Professor at the University of the West Indies.
About Less Exposure Surgery
Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.
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The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.
Scientific Paper Author & Citation Details
- Division of Spine Surgery, Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania and the University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. firstname.lastname@example.org