Alterations in Swallowing Six Weeks After Primary Anterior Cervical Discectomy and Fusion (ACDF).
R Brynn Jones-Rastelli, Milan R Amin, Matina Balou and 2 others
PMID 38157009WHAT IT FOUND
Six weeks after ACDF surgery, patients had significantly more pharyngeal residue due to reduced constriction, but airway protection remained intact with no aspiration.
This suggests swallowing efficiency is impaired more than safety at this stage.
Key findings
01Total pharyngeal residue significantly increased between preoperative and postoperative timepoints with a moderate effect.
02There was no significant difference in worst Penetration-Aspiration Scale scores between time points, and no episodes of tracheal aspiration were observed.
03Maximum pharyngeal constriction worsened postoperatively, and posterior pharyngeal wall thickness increased, indicating residual edema.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (21 participants) and homogeneous, consisting primarily of younger, relatively healthy men. The study was underpowered, which may have contributed to the lack of significant findings in some secondary measures. Raters could not be blinded to the timepoint because cervical hardware is visible on fluoroscopy. Findings may not generalize to older patients, those with comorbidities, or women.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government research support.
The easy way to misread this
Do not conclude that ACDF surgery is safe for swallowing overall. This study only looked at six weeks post-op in a specific, healthy cohort. The increase in residue indicates impaired efficiency that could impact nutrition or comfort, even without aspiration.