{"doi":"10.1016/j.wneu.2025.124374","title":"The Risk of Dysphagia After Short-Segment Posterior Occipital-C2 Fusion versus C1-C2 Cervical Fusion: A Retrospective Cohort Study","abstract":"OBJECTIVE: We examined whether short-segment posterior occipital-C2 (O-C2) fusion is associated with a higher risk of postoperative dysphagia than short-segment posterior C1-C2 fusion to enhance preoperative education and shared decision-making. METHODS: This database study (TriNetX) included two cohorts (≥18 years old) who underwent either posterior O-C2 or C1-C2 fusion without extension into the subaxial cervical or thoracic spine. The primary outcome was the risk ratio (RR) of dysphagia, based on the incidence through 2 years. Secondary outcomes included RRs of potential oropharyngeal/respiratory complications and procedures. RESULTS: There were 371 patients per cohort (mean age: 55 years). Comparing O-C2 to C1-C2 fusion through 2 years, there was a statistically significant increase in risk of dysphagia (RR: 1.97 [1.38, 2.82]; P < 0.001; 20.8% vs. 10.5%), with a median time to 50% of events of 11.0 days and 36.3 days, respectively. For secondary outcomes, there was a statistically significant increased risk of obstructive sleep apnea (RR: 2.07 [1.11, 3.86]; P = 0.018), speech therapy (RR: 2.04 [1.32, 3.16]; P = 0.001), and swallowing evaluation (RR: 1.85 [1.25, 2.74]; P = 0.002) and small nonsignificant increases in risk of dyspnea (RR: 1.30 [0.83, 2.05]; P = 0.255) and pneumonia (RR: 1.09 [0.63, 1.88]; P = 0.765). CONCLUSIONS: Compared to C1-C2 fusion, O-C2 fusion was associated with a nearly 2-fold increase in risk of dysphagia through 2 years, along with potential increases in other oropharyngeal and respiratory complications. Surgeons should be aware of these findings when planning O-C2 versus C1-C2 fusion. LEVEL OF EVIDENCE: Level III.","journal":"World Neurosurgery","year":2025,"id":534432,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8122,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1093360,"name":"Robert J. Trager","orcid":"0000-0002-4714-1076","position":1,"is_corresponding":false},{"id":1415420,"name":"Omkar Anaspure","orcid":"0000-0001-9135-0484","position":2,"is_corresponding":false},{"id":1417581,"name":"Nicole A. Baumann","orcid":null,"position":3,"is_corresponding":false},{"id":1417045,"name":"Wyatt L. Ramey","orcid":"0000-0003-2782-9479","position":4,"is_corresponding":false},{"id":1396250,"name":"Jacob C. Hoffmann","orcid":null,"position":5,"is_corresponding":false},{"id":1263763,"name":"Anthony N. Baumann","orcid":"0000-0002-4175-3135","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T02:51:47.434742Z","pmid":"40812770","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}