Abstract
Dysphagia is associated with poor quality of life, and pneumonia due to aspiration is life-threatening. Cervical ossification of the anterior longitudinal ligament (C-OALL) is one of the causes of dysphagia, and we report two cases in which dysphagia improved after surgery. Case 1: A 76-year-old man had C-OALL of greater than 16 mm and dysphagia and developed myelopathy. A fall resulted in upper and lower limb insufficiency paralysis, and posterior decompression fixation was performed. Pressure on the pharynx by C-OALL remained, but dysphagia improved. Improvement in this case was considered to be due to the loss of intervertebral mobility. Case 2: A 62-year-old man developed dysphagia 6 years ago. It gradually exacerbated, and the C-OALL increased. Laryngeal fiberscope and swallowing angiography revealed that the pharyngeal cavity was compressed and narrowed anteriorly due to ossification. Resection of the ossification was performed, and the patient’s symptoms improved. Direct decompression was successful in this case. Several evaluation methods for dysphagia have been reported, including screening tests, endoscopy, contrast studies, and radiological evaluation. In case 1, extensive ossification was improved by posterior fixation, albeit incidentally, whereas in case 2, a patient with extensive ossification exhibited symptoms. It is necessary to examine the cervical mobility, extent and morphology of ossification, and timing of surgery stenosis to determine the risk factors and treatment options, including rehabilitation.
Highlights
A significant reduction in occipito-C2 angle (O-C2A) was correlated with a decrease considered that the dysphagia should be predicted at the condition of pharyngeal inlet angle (PIA) < 90°, where in oropharyngeal space and postoperative dysphagia [14,15]
Keneyama et al considered the of the midcervical sagittal curvature protruded to the thatapex the dysphagia should be predicted at the condition of PIA anterior
We reported two cases of dysphagia due to cervical ossification of the anterior longitudinal ligament (C-OALL) at the C3/4 level with an initial symptom of dysphagia
Summary
The incidence of dysphagia among patients diagnosed with C-OALL is not low, with. Resnick reporting it to be 17–28% [2]. Resection of C-OALL is selected [10,11,12], but it is not clear whether resection of the ossification foci alone can improve swallowing, as the thickness of the ossification or timing of surgery does not necessarily correlate with dysphagia [13]. In case 1, different from previous reports, posterior fixation incidentally improved dysphagia dysphagia [13]. In case 1, different from previous reports, posterior fixation incidentally improved dyspha of 10 resecgia without anterior resection, and in case 2, dysphagia improved after ossification tion. There is still a controversial research area reporting intervertebral mobility and withoutofanterior resection, in case
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