Fluoroscopic Swallowing Abnormalities in Dysphagic Patients Following Anterior Cervical Spine Surgery

2020 ◽  
Vol 129 (11) ◽  
pp. 1101-1109
Author(s):  
Shumon Ian Dhar ◽  
Adam M. Wegner ◽  
Pope Rodnoi ◽  
John C. Wuellner ◽  
Omid Benjamin Mehdizadeh ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Vocal Fold ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Immobility Time ◽  
Swallowing Dysfunction ◽  
Vocal Fold Immobility ◽  
The Mean ◽  
Ues Opening

Objectives: To evaluate the precise objective fluoroscopic abnormalities in persons with dysphagia following anterior cervical spine surgery (ACSS). Methods: 129 patients with dysphagia after ACSS were age and sex matched to 129 healthy controls. All individuals underwent videofluoroscopic swallow study (VFSS). VFSS parameters abstracted included upper esophageal sphincter (UES) opening, penetration aspiration scale (PAS), and pharyngeal constriction ratio (PCR). Other data collected included patient-reported outcome measures of voice and swallowing, number of levels fused, type of plate, vocal fold immobility, time from surgery to VFSS, and revision surgery status. Results: The mean age of the entire cohort was 63 (SD ± 11) years. The mean number of levels fused was 2.2 (±0.9). 11.6% (15/129) were revision surgeries. The mean time from ACSS to VFSS was 58.3 months (±63.2). The majority of patients (72.9%) had anterior cervical discectomy and fusion (ACDF). For persons with dysphagia after ACSS, 7.8% (10/129) had endoscopic evidence of vocal fold immobility. The mean UES opening was 0.84 (±0.23) cm for patients after ACSS and 0.86 (±0.22) cm for controls ( P > .0125). Mean PCR was 0.12 (±0.12) for persons after ACSS and 0.08 (±0.08) for controls, indicating significant post-surgical pharyngeal weakness ( P < .0125). The median PAS was 1 (IQR 1) for persons after ACSS as well as for controls. For ACSS patients, PCR had a weak correlation with EAT-10 ( P < .0125). Conclusion: Chronic swallowing dysfunction after ACSS appears to be secondary to pharyngeal weakness and not diminished UES opening, the presence of aspiration, vocal fold immobility, or ACSS instrumentation factors. Level of Evidence: 3b

Recurrent Laryngeal Nerve Palsy after Anterior Cervical Spine Surgery

2006 ◽  
Vol 105 (5) ◽  
pp. 898-901 ◽  
Author(s):  
Paul Audu ◽  
Greg Artz ◽  
Sarah Scheid ◽  
James Harrop ◽  
Todd Albert ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Recurrent Laryngeal Nerve ◽  
Endotracheal Tube ◽  
Spine Surgery ◽  
Vocal Fold ◽  
Laryngeal Nerve ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Vocal Fold Immobility ◽  
Vocal Fold Motion

Background Vocal fold immobility (paresis or paralysis) from recurrent laryngeal nerve injury remains an important cause of morbidity after anterior cervical spine surgery. A maneuver involving endotracheal tube (ETT) cuff manipulation has been proposed to reduce its incidence. This study is a randomized, prospective, double-blind investigation to test the hypothesis that ETT cuff manipulation reduces the incidence of postoperative vocal fold immobility after anterior cervical spine surgery. Methods One hundred patients scheduled to undergo anterior cervical spine surgery were randomly assigned to one of two groups. After inducing general endotracheal anesthesia, patients in the intervention group had their ETT cuff pressures maintained at 20 mmHg or less. After placement of self-retaining retractors, the ETT cuff was deflated for 5 s and then reinflated. Patients in the control group had no further manipulation of their ETT once the cuff was inflated after intubation. Cuff pressures in both groups were recorded before skin incision (baseline) and after placement of self-retaining retractors (peak). Patients' vocal fold motion was evaluated by indirect laryngoscopy performed preoperatively and postoperatively. The examination was videotaped and reviewed by a blinded otolaryngologist. Postoperative vocal fold motion was graded as normal, paretic, or paralyzed. Results Complete data were available in 94 patients. The incidence of vocal fold paralysis was 3.2% (95% confidence interval, 0.7-9.4%). Cuff manipulation decreased ETT cuff pressure but did not reduce the incidence of vocal fold immobility (15.4% vs. 14.5%). Conclusion Endotracheal tube cuff deflation/reinflation and pressure adjustment do not reduce the incidence of vocal fold immobility in anterior cervical spine surgery.

scholarly journals Characterization of dysphagia following anterior cervical spine surgery

2021 ◽  
pp. 1-8
Author(s):  
John P. Ziegler ◽  
Kate Davidson ◽  
Rebecca L. Cooper ◽  
Kendrea L. Garand ◽  
Shaun A. Nguyen ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Barium Swallow ◽  
Control Group ◽  
Early Group ◽  
Pharyngeal Wall ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Swallowing Dysfunction ◽  
Group 1

BACKGROUND: Post-operative dysphagia is one of the most common complications of anterior cervical spine surgery (ACSS). OBJECTIVE: Examine post-operative structural and physiologic swallowing changes in patients with dysphagia following ACSS as compared with healthy age and gender matched controls. METHODS: Videofluoroscopic swallow studies of adults with dysphagia after ACSS were retrospectively reviewed. Seventy-five patients were divided into early (≤2 months) and late (>  2 months) post-surgical groups. Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale (PAS) scores, and pharyngeal wall thickness (PWT) metrics were compared. RESULTS: Significant differences were identified for all parameters between the control and early post-operative group. MBSImP Pharyngeal Total (PT) scores were greater in the early group (Interquartile Range (IQR) = 9–14, median = 12) versus controls (4–7, 5, P <  0.001) and late group (0.75–7.25, 2, P <  0.001). The early group had significantly higher maximum PAS scores (IQR = 3–8, median = 7) than both the control group (1–2, 1, P <  0.001) and late post-operative group (1–1.25, 1, P <  0.001). PWT was significantly greater in the early (IQR = 11.12–17.33 mm, median = 14.32 mm) and late groups (5.31–13.01, 9.15 mm) than controls (3.81–5.41, 4.68 mm, P <  0.001). CONCLUSION: Dysphagic complaints can persist more than two months following ACSS, but often do not correlate with validated physiologic swallowing dysfunction on VFSS. Future studies should focus on applications of newer technology to elucidate relevant deficits.

Delayed pharyngo-oesophageal perforation after anterior cervical spine surgery

2020 ◽  
Vol 66 (5) ◽  
pp. 414-416
Author(s):  
V. Poissonnet ◽  
V. Lubrano ◽  
A. Sadeler ◽  
E. Chabrillac
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Oesophageal Perforation ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

Traction Diverticulum of the Hypopharynx following Anterior Cervical Spine Surgery

1991 ◽  
Vol 100 (10) ◽  
pp. 852-855 ◽  
Author(s):  
Yves Goffart ◽  
Jacques Lenelle ◽  
Pierre Moreau ◽  
Jean Boverie
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery

Clinical efficacy analysis of the new PRUNUS spine plate system for anterior cervical spine surgery

2020 ◽  
Author(s):  
Xiao-feng Zhao ◽  
Xiang-dong Lu ◽  
Yi-bo Zhao ◽  
De-tai Qi ◽  
Wen-xuan Wang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Blood Loss ◽  
Internal Fixation ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Cervical Surgery ◽  
Plate System

Abstract BACKGROUND To observed and evaluated the clinical efficacy of a new type cervical anterior screw plate system development for anterior cervical surgery. Methods 27 patients with cervical spine disease treated with new PRUNUS nail plate internal fixation were selected as observation group, and 29 patients treated with conventional cervical anterior screw fixation were selected as the control group. Cervical stability, internal fixation position and bone graft fusion were evaluated according to imaging data. The operative time, intraoperative blood loss, cervical Cobb angle, VAS scores, and JOA scores were compared between the two groups. Spinal function scores and neurological improvement rates were used to evaluate the clinical efficacy of the new PRUNUS spine plate. Results There were statistical differences in operation time and blood loss between the two groups (P<0.05). The difference in Cobb angle, JOA score and improvement rate, VAS score before and after surgery in two groups were statistically significant (P<0.05), but no significant differences between two groups (P>0.05). Conclusion The new PRUNUS spine plate system can be applied to the anterior cervical spine surgery, and its clinical efficacy was similar to the traditional cervical anterior plate. But PRUNUS simplified the operation process, especially for the osteoporosis patients.

scholarly journals Anterior cervical spine surgery-associated complications in a retrospective case-control study

2017 ◽  
Vol 3 (3) ◽  
pp. 444-459 ◽  
Author(s):  
Anastasia Tasiou ◽  
Theofanis Giannis ◽  
Alexandros G. Brotis ◽  
Ioannis Siasios ◽  
Iordanis Georgiadis ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Control Study
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