Impact of Postoperative Dysphagia on Health Care Resource Utilization Following Single-Level Cervical Disc Arthroplasty

Introduction: Dysphagia is a well-documented complication following cervical spine surgeries. While cervical disc arthroplasty (CDA) is a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF) and has shown lower rates of dysphagia compared to ACDF, postoperative dysphagia remains a significant concern. This study seeks to highlight differences in 1) postoperative complications, 2) recovery course, and 3) associated costs between patients with and without postoperative dysphagia who underwent single-level CDA.

Methods: The National Inpatient Sample (NIS) was queried to identify patients who underwent single-level CDA between 2016 and 2020. After applying exclusion criteria, patients were divided into dysphagia and control groups based on the presence or absence of postoperative dysphagia. Propensity score-matching (1:5) was performed, accounting for age, sex, race, and comorbidities. Primary outcomes included length of stay (LOS), hospital costs, and discharge disposition, while secondary outcomes focused on the incidence of perioperative complications. Chi-square and t-tests were used for statistical comparisons. Statistical significance was set at the 0.05 level.

Results: The final analysis included 640 patients in the dysphagia group and 3,200 controls after matching. Patients in the dysphagia group experienced a significantly higher rate of perioperative complications (7.8% vs. 2.8%; P = 0.006). The mean LOS was longer for the dysphagia group (2.9 ± 0.3 days vs. 1.5 ± 0.1 days; P < 0.001), and hospitalization costs were significantly higher ($27,100 vs. $21,700; P < 0.001). Additionally, dysphagia patients were more likely to have a non-routine discharge (15.6% vs. 9.2%; P = 0.030).

Conclusion : Postoperative dysphagia following CDA significantly escalates healthcare resource utilization, leading to prolonged hospital stays, increased costs, and a greater risk of non-routine discharge. This underscores the need for targeted interventions to reduce the incidence of dysphagia and improve recovery outcomes, ultimately enhancing patient care and reducing the financial burden on healthcare systems.