Abstract
Dysphagia is a common complication following anterior cervical spine surgery and may occur in over 70% of patients. There is an emerging evidence that dysphagia also appears after posterior cervical spine surgery. Nevertheless, hardly any study is focusing on changes in swallowing physiology with regard to surgical approach. Aim of this study: To investigate changes in swallowing physiology following: 1. anterior cervical spine surgery, and 2. posterior cervical spine surgery. Methods: A standardized videofluoroscopic swallowing study (VFSS) was performed in 28 patients who underwent cervical spine surgery (anterior approach n = 19, Mage 56±14; posterior approach n = 9, Mage 58±17) one day before surgery and after surgery (mean 4 days). Data were analyzed retrospectively with the Modified Barium Swallow Impairment Profile (MBSImPTM©). Results: 1. In the anterior group, pharyngeal sum score was significantly higher after surgery (p < .001). Significant changes were found in 4 out of 8 analyzed pharyngeal components. 2. In the posterior group, pharyngeal sum score was significantly higher after surgery (p = .015). No significant changes were found in the oral or pharyngeal components. Conclusions: Whereas more changes in swallowing physiology occurred following anterior surgery, there were also overall changes in the posterior group. Understanding the swallowing pathophysiology associated with cervical spine surgery is indispensable to decrease the rate of secondary complications and improve quality of life for this patients.
Highlights
Dysphagia is a common complication following anterior cervical spine surgery
Pre-surgical Videofluoroscopic Swallowing Study (VFSS) was performed the day before surgery; post-surgical VFSS was conducted a median of 4 days after surgery
Proposed mechanisms leading to dysphagia include direct surgical trauma, neuropraxia from nerve traction, and postoperative edema [33]
Summary
Dysphagia is a common complication following anterior cervical spine surgery. It may occur in over 70% of patients having undergone anterior cervical spine procedures [1,2,3,4,5,6,7,8]. Patients having undergone anterior cervical spine surgery incur swallowing problems. It has been determined that dysphagia is observed following posterior cervical spine surgery [9,10,11]. Mechanical aspects such as esophagus or soft tissue retraction, postoperative swelling or hematoma, can be excluded as causes for dysphagia in posterior surgical patients. The importance of swallowing physiology changes post-operatively in both anterior and posterior surgical approaches should not be overlooked
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