Dysphonia following anterior cervical discectomy and fusion: a PearlDiver analysis of incidence, risk factors, and interventions.

OBJECTIVE

This study aimed to determine the incidence of post-operative dysphonia following anterior cervical discectomy and fusion, identify associated risk factors and assess utilisation of diagnostic and therapeutic interventions.

METHODS

This retrospective cohort study analysed data from the PearlDiver Mariner Patient Records Database (2010-2022). Adults (≥18 years) undergoing primary anterior cervical discectomy and fusion without pre-existing dysphonia were included (n = 613,978). Outcomes included incidence, risk factors (odds ratios, 95 per cent confidence intervals) and intervention rates.

RESULTS

Dysphonia occurred in 2.6 per cent of patients. Risk factors included female sex (odds ratio 1.43), age 50-64 (odds ratio 1.10), 65-79 (odds ratio 1.21), smoking (odds ratio 2.41), obesity (odds ratio 2.80), diabetes (odds ratio 1.89) and multilevel anterior cervical discectomy and fusion (odds ratio 1.20) (p < 0.01). Diagnosis was delayed (>12 months) in 73.2 per cent. Only 52.7 per cent underwent laryngoscopy; 15.0 per cent received voice therapy.

CONCLUSION

Post-operative dysphonia is under-recognised and undertreated. Structured screening and otolaryngology referral pathways may improve diagnosis and management.