Day: July 24, 2026

J Neurosurg Spine 45:19–29, 2026

This clinical study evaluates whether preoperative diabetes increases the risk and severity of postoperative dysphagia after cervical spine surgery, using prospectively collected multi-institutional registry data and validated EAT-10 scores at baseline and 1, 3, and 12 months. Multivariable mixed-effects logistic regression identified diabetes as an independent predictor of dysphagia at 1 and 3 months, with higher incidence and worse PROMs in diabetic patients.

The cohort of 2001 patients (20% with diabetes) demonstrated significantly greater new postoperative dysphagia and higher EAT-10 score changes among diabetics, particularly after anterior procedures; however, diabetes did not independently predict dysphagia at 12 months. The authors discuss clinical implications, limitations (lack of HbA1c and neuropathy data), and recommend surgeons counsel patients about elevated short-term dysphagia risk.

Objective Relationship between preoperative diabetes and incidence of postoperative dysphagia after cervical spine surgery, assessed using EAT-10 at baseline and 1, 3, and 12 months post-op

Cohort 2001 cervical spine surgery patients; 400 (20%) had diabetes; baseline dysphagia rates were not significantly different (18% diabetes vs 14% no diabetes)

Higher dysphagia rates Patients with diabetes had higher postoperative dysphagia incidence at 1 month (66% vs 54%), 3 months (39% vs 26%), and 12 months (33% vs 24%)

Independent prediction (all patients) After adjusting for baseline dysphagia and other factors, diabetes independently predicted postoperative dysphagia at 1 month (OR 1.46) and 3 months (OR 1.63), but not at 12 months (OR 1.21)

New dysphagia (no baseline dysphagia) Among patients without baseline dysphagia, diabetes was associated with higher new dysphagia at 1 month (62% vs 50%), 3 months (34% vs 21%), and 12 months (27% vs 18%)

Independent prediction (new dysphagia) In those without baseline dysphagia, diabetes independently predicted new dysphagia at 1 month (OR 1.49) and 3 months (OR 1.81), but not at 12 months (OR 1.31)

Symptom severity change Mean EAT-10 change from baseline to 12 months was worse with preoperative diabetes (2.440 ± 5.013 vs 1.688 ± 4.139) among those without baseline dysphagia

Conclusion Diabetes is a significant risk factor for postoperative dysphagia after cervical spine surgery, with strongest independent effect at early time points (1 and 3 months)