Treatment of Cervical Spondylosis With Dysphagia Caused by Anterior Osteophytes: A Retrospective Case Series Study.

Abstract

ObjectiveThis study aimed to evaluate the clinical characteristics, surgical outcomes, and prognostic factors of cervical spondylosis in patients with dysphagia caused by anterior osteophytes.MethodsThis retrospective study included 28 patients who underwent anterior cervical surgery for dysphagia associated with anterior osteophytes between January 2006 and January 2023. Clinical data, including preoperative evaluations, surgical reports, and follow-up visits, were collected from electronic medical records. Cervical spine degeneration was confirmed by radiographic examinations. Dysphagia severity was assessed by the Functional Outcome Swallowing Scale (FOSS) preoperatively and at follow-up. Statistical analyses were conducted to compare pre- and postoperative outcomes.ResultsThe average age was 62.4 years, and 78.6% were men. All patients experienced dysphagia, with severity ranging from grades 1-4. After surgery, 89.3% of the patients showed symptomatic improvement, defined as a reduction of at least one grade on the FOSS. Complications were infrequent, primarily consisting of axial pain (10.7%), along with less common occurrences of esophageal fistula, stenosis, nutritional insufficiency, and myelitis (each at 3.6%). Both the modified Japanese Orthopaedic Association (mJOA) score and Neck Disability Index (NDI) showed significant postoperative improvement. The most frequently involved segments were C5/6 and C4/5.ConclusionAnterior cervical osteophyte resection, with or without fusion, appears effective in relieving dysphagia symptoms and improving neurological function in well-selected patients. Further prospective studies are needed to validate these findings and refine surgical strategies.