Anterior Cervical Surgery Ups GERD Incidence, Severity

Anterior cervical decompression, fusion surgery patients require an average 1.2 antacid doses

FRIDAY, Nov. 11 (HealthDay News) -- The incidence and severity of gastroesophageal reflux disease (GERD) in patients undergoing anterior cervical decompression and fusion (ACDF) is higher than that of patients undergoing posterior lumbar decompression, according to a study published in the Nov. 15 issue of Spine.

Jeffrey A. Rihn, M.D., from Thomas Jefferson University Hospital in Philadelphia, and colleagues examined the effects of ACDF on the incidence and severity of GERD by comparing 38 patients undergoing one- or two-level ACDF versus 56 patients undergoing posterior lumbar decompression (controls). Patient characteristics were recorded at baseline, and their intra- and postoperative medical records reviewed. Participants were administered a GERD Impact scale (GIS), and a dysphagia questionnaire preoperatively, and during the week-two, -six and -12 postoperative visits.

The investigators found that, compared to controls, the cervical patients had higher incidence of GERD, which was statistically significant at two weeks, but not at six and 12 weeks. The cervical group had significantly higher changes in GIS scores from baseline at all follow-up periods. Postoperatively, the lumbar patients required an average of 0.5 doses of antacid medications, while cervical patients required an average of 1.2 doses. Severity of dysphagia and GIS score correlated significantly at two weeks, but not at six or 12 weeks. No correlation was observed between operative time and GIS score at any follow-up period. GIS score remained unaffected by the number of surgical levels (one versus two) or level of surgery (above versus below C5 to C6).

"Compared to the lumbar control group, patients undergoing anterior cervical decompression and fusion had increased incidence and severity of GERD-like symptoms in the early postoperative period," the authors write. "Given the differences noted between groups, it is likely that postoperative GERD is largely due to the anterior cervical surgery itself rather than the process of endotracheal intubation."

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