Adaptation and Implementation of the Dysphagia and Dysphonia Inventory (HSS-DDI) in Greek Patients After Anterior Surgical Removal of the Herniated Cervical Spine

Background: Anterior cervical discectomy and fusion (ACDF) is a widely performed surgical intervention for cervical spine herniation (CSH) to alleviate symptoms such as pain, weakness, and restricted mobility. Despite its efficacy, ACDF is associated with postoperative complications, notably dysphagia and dysphonia (PDD). Objective: This study investigates the prevalence, severity, and risk factors associated with PDD following ACDF using the validated Dysphagia and Dysphonia Inventory (HSS-DDI) adapted into Greek. Methods: A prospective observational cohort study was conducted at the University General Hospital of Ioannina from May to November 2023. The study involved 40 adult patients who underwent ACDF for CSH. Postoperative dysphagia and dysphonia were assessed using the Ohkuma questionnaire and HSS-DDI at 1 week and 1 month postoperatively. Results: The mean age of participants was 54.78 years, with a majority being male (60%). In terms of body mass index (BMI), 30% of participants had a normal weight, 47.5% were overweight, and 22.5% were obese. This study revealed that dysphagia and dysphonia were common postoperative complications, with improvements noted after one month. Factors such as BMI were statistically significant in influencing dysphagia outcomes, with normal BMI individuals reporting better outcomes than obese participants. Confirmatory factor analysis indicated the need for a larger sample size to confirm subscale validity in the Greek population. Conclusions: Postoperative dysphagia and dysphonia are prevalent following ACDF, but most patients experience improvements within a short period. Identifying risk factors, such as BMI, and utilizing validated assessment tools like the HSS-DDI can help optimize surgical techniques and postoperative care. Further studies with larger sample sizes are recommended for a more comprehensive understanding of these complications.