I understand that having neck surgery from the front can damage my vocal cords and/or leave me with difficulty swallowing. But if they know this is a problem, why can't they figure out a better way of doing the surgery to keep it from happening? This seems like a potentially serious problem -- maybe even worse than the neck pain I'm having.

Dysphagia (difficulty swallowing) and odynophagia (painful swallowing) are common problems following anterior (from the front) cervical spine (neck) surgery. Surgeons are actively researching to figure out why this happens so they can put a stop to it. What do we know so far? Studies have shown us that performing spine surgery from the front or the back each has its own advantages and disadvantages. Coming in from the front avoids damaging the spinal cord and spinal nerve roots. The posterior (from the back) approach is much more likely to be linked with this type of damage to the nerve tissue. But moving the esophagus aside during anterior surgery and/or accidentally cutting the nerves to the vocal cords can result in some serious problems. Difficulty swallowing, painful swallowing, and loss of voice control are some of those potentially disabling complications. It's also possible that bone spurs present even before the cervical spine surgical procedure is done may contribute to the problem after surgery. Other studies have pointed to older age as a possible risk factor for dysphagia after anterior cervical surgery but not all study results agree on this one. Vertebral fusion at more than one level may also be a risk factor for dysphagia. Once we know what the risk factors are for postsurgical dysphagia, then we can start to predict who might develop such problems and prevent them. Careful patient selection is part of the process (i.e., avoiding doing anterior spine surgery on anyone with significant risk factors). Developing improved surgical tools and techniques is also part of the solution. Most of the time, the symptoms are transient temporary and only last for up to three weeks. But that's not very comforting for patients who develop chronic or permanent dysphagia. Be assured that efforts are being made to study this problem and prevent it from happening.

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