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Swallowing performance following anterior cervical spine surgery
M Stewart1, R A Johnston, I Stewart
1Department of Otolaryngology Head and Neck Surgery, Royal Infirmary, Glasgow, UK.
British Journal of Neurosurgery
|January 1, 1995
Summary
A significant number of patients experience dysphagia (swallowing difficulty) after anterior cervical spine surgery. While often transient, about 10% face persistent issues, with manometry proving more effective than radiology for diagnosis.
Area of Science:
- Neurosurgery
- Gastroenterology
- Otolaryngology
Background:
- Anterior cervical spine surgery is common for cervical spondylosis.
- Dysphagia is a potential complication, but its incidence and persistence require further assessment.
Purpose of the Study:
- To determine the incidence and severity of dysphagia after anterior cervical spine surgery.
- To evaluate diagnostic methods for postoperative dysphagia.
Main Methods:
- A cohort of 100 patients undergoing anterior cervical spine surgery were surveyed 12-22 months post-op.
- Respondents reporting dysphagia were invited for further investigation, including radiological examination and manometry.
Main Results:
- 45% of respondents (33/73) reported postoperative dysphagia.
- Dysphagia persisted beyond 6 months in 12% of respondents (9/73).
- Manometry indicated pharyngo-esophageal segment hyperactivity in investigated patients, despite normal radiological findings.
Conclusions:
- Surgeons should counsel patients on the high risk of transient dysphagia (45%) and the potential for persistence (approx. 10%).
- Manometry is the preferred diagnostic tool, as radiological findings may be normal.
- Severe persistent dysphagia may benefit from interventions like cricopharyngeal myotomy or pharyngeal dilatation.