The Effect of Esophageal Temperature Probes on Postoperative Dysphagia Following Primary Anterior Cervical Discectomy and Fusion: A Randomized Prospective Study

Background The anterior approach to the cervical spine is associated with postoperative dysphagia. It is difficult to predict which patients are most at risk for dysphagia. The objective of this study was to determine if placing an esophageal temperature probe preoperatively would affect the severity and length of postoperative dysphagia. We hypothesize that use of an esophageal temperature probe would result in worse postoperative dysphagia at all measured time points as measured by the Swallowing-Quality of Life (SQAL-QOL) survey after anterior cervical discectomy and fusion (ACDF).

Methods A total of 44 patients were enrolled in a prospective, randomized controlled trial and randomized into groups: 1 with an esophageal temperature probe placed at the time of surgery and 2 without. A total of 39 patients filled out postoperative SWAL-QOL questionnaires at their preoperatives. Using the survey results, the data were analyzed between groups and subanalyzed based on number of operative levels and sex.

Results SWAL-QOL scores for patients undergoing 2-level ACDF with an esophageal temperature probe were significantly better compared with those without a probe at 2 weeks and 6 months postoperatively. These results were not significant at other time points in in the overall analysis, but a trend toward improved dysphagia scores at each time point postoperatively was seen with the probe group. No differences were found between the 2 groups with respect to age at the time of surgery, sex, and preoperative SWAL-QOL score.

Conclusions Placement of an esophageal temperature probe at the time of surgery significantly improved postoperative dysphagia scores in patients undergoing 2-level ACDF at 2 weeks and 6 months postoperatively.

Level of Evidence 2

Clinical Relevance Placement of a temperature probe is a safe and effective technique that is readily available and easily applicable to the practice of spine surgery and may improve postoperative dysphagia after ACDF.