Treating anterior cervical osteophytectomy with surgery can improve outcomes, however research suggests that there may be concerns with cervical spine motion if cervical osteophytectomy with cervical discectomy and fusion plate system is performed.
Dysphasia and Cervical Osteophytectomy Connection?
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Secondary#cervicaldiscectomy#cervicalosteophytectomy#fusionplatesystem
In the study, “Surgical management of Diffuse Idiopathic Skeletal Hyperostosis (DISH) causing secondary dysphagia,” the researchers summarize current evidence on surgical treatment for large bridging osteophytes of the anterior cervical spine from diffuse idiopathic skeletal hyperostosis.
The findings are published in the September to December 2021 issue of the Journal of Orthopaedic Surgery.
The researchers wrote, “In the current review, the surgical treatment of secondary dysphagia from DISH was the most useful treatment. We propose a treatment algorithm for management of this condition because currently there are only case reports and retrospective studies.”
Their systematic review included 11 articles published between January 2000 and February 2020.
Overall, incidence of secondary dysphagia was associated with DISH in elderly patients. The major clinical findings were dysphagia or respiratory compromise, with the most common level of bridging osteophytes of the cervical spine at C3–C5.
There were 10 articles on surgical treatment involving anterior cervical osteophytectomy without fusion, 1 for multilevel cervical oblique corpectomy, 1 for anterior cervical discectomy with fusion plus plate, and 1 for anterior cervical osteophytectomy with stand-alone PEEK cage or plus plate.
In all cases significant improvement without recurrence was observed. There was only 1 case having post-operative complications.
“Surgical intervention for anterior cervical osteophytectomy appears to result in improved outcomes. However, there could be disadvantages concerning cervical spine motion if cervical osteophytectomy with cervical discectomy and fusion (ACDF) plus plate system is done,” the researchers wrote.
Study authors include Torphong Bunmaprasert, Jakkrit Keeratiruangrong, Nantawit Sugandhavesa, Wongthawat Liawrungrueang, all of Chiang Mai University in Thailand and K Daniel Riew, M.D. of Weill Cornell Medicine.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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