Abstract
Anterior cervical spine surgery (ACSS) is an effective treatment for various cervical spine conditions but carries a risk of recurrent laryngeal nerve (RLN) injury and dysphonia. This systematic review and meta-analysis aimed to evaluate the incidence of these complications and their associated risk factors. An analysis of 17 studies involving 5,706 patients revealed a pooled RLN injury incidence of 3.41% and a dysphonia incidence of 2.5%. Prolonged surgeries exceeding two hours and multilevel procedures were associated with higher risks, while implant material demonstrated minimal impact. These findings highlight the importance of surgical planning to mitigate RLN injury risk and improve patient outcomes in ACSS.