Characterization of dysphagia following anterior cervical spine surgery

Ziegler, John P.; Davidson, Kate; Cooper, Rebecca L.; Garand, Kendrea L Focht; Nguyen, Shaun A.; Martin‐Harris, Bonnie; O’Rourke, Ashli

doi:10.3233/acs-210034

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…These biomechanical deficits largely explain the functional consequences observed on instrumental studies, most notably impaired swallowing efficiency (post-swallow residue) [36-38, 40, 42, 43]. Aspiration has also been documented in this population, but primarily of post-swallow residue [11,36,41] and/or in the acute phase [44]. VFSS has also been used to document significant pre-vertebral swelling post-ACDF [11,36,39,40,42,44]; though, this can also be easily captured from routine lateral view radiographs.…”

Section: Discussionmentioning

confidence: 99%

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A scoping review of the methods used to capture dysphagia after anterior cervical discectomy and fusion: the need for a paradigm shift

et al. 2023

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Objective Dysphagia is the most commonly reported complication of annterior cervical discectomy and fusion (ACDF) surgery. However, the incidence of dysphagia post-ACDF varies widely–partly attributable to differing outcome measures used to capture dysphagia. Our objective was to conduct a scoping review of the literature to quantify which dysphagia outcome measures have been employed post-ACDF and examine trends by study design, year, and location. Methods After removing duplicates, 2396 abstracts were screened for inclusion. A total of 480 studies were eligible for full-text review. After applying exclusion criteria, data was extracted from 280 studies. We extracted the dysphagia outcome measure(s), study design (prospective vs retrospective), year, and location (country). Approximately 10% of studies were repeated for intra-rater agreement. Results In total, 317 dysphagia outcome measures were reported in 280 studies (primarily retrospective—63%). The largest proportion of outcome measures were categorized as “unvalidated patient-reported outcome measures” (46%), largely driven by use of the popular Bazaz scale. The next most common categories were “insufficient detail” and “validated patient-reported outcome measures” (both 16%) followed by “chart review/database” (13%) and instrumental assessment (7%). Studies examining dysphagia post-ACDF steadily increased over the years and the use of validated measures increased in the past 10 years. Conclusions This scoping review of the literature highlights that nearly half of the ACDF dysphagia literature relies on unvalidated patient-reported outcome measures. The current understanding of the mechanism, timeline, and presentation of dysphagia post-ACDF are likely limited due to the metrics that are most commonly reported in the literature.

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Section: Discussionmentioning

confidence: 99%

“…Aspiration has also been documented in this population, but primarily of post-swallow residue [11,36,41] and/or in the acute phase [44]. VFSS has also been used to document significant pre-vertebral swelling post-ACDF [11,36,39,40,42,44]; though, this can also be easily captured from routine lateral view radiographs.…”

Section: Discussionmentioning

confidence: 99%

A scoping review of the methods used to capture dysphagia after anterior cervical discectomy and fusion: the need for a paradigm shift

et al. 2023

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“…In several previous studies, old age, the presence of tracheostomy, vocal quality, the anterior surgical approach for the cervical spine (lower level of anterior cervical spine operation), higher level of neurological injury (American Spinal Cord Injury Association (ASIA) grade A or B), and reduced performance on pulmonary function testing (such as low forced expiratory volume for 1 s (FEV1) and low peak cough flow (PCF)) have been reported as risk factors for dysphagia in patients with C-SCI [2,[7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury

Lee

Kim

Choi

et al. 2023

JCM

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Introduction: Early detection and management of dysphagia are essential for preventing aspiration pneumonia and reducing mortality in patients with cervical spinal cord injury (C-SCI). In this study, we identified risk factors for dysphagia in patients with C-SCI by analyzing the correlation between the clinical factors and the severity of dysphagia, not the presence or absence of dysphagia. Combined with the analysis results of previous studies, we thought that this additional analysis method could more accurately reveal the risk factors for dysphagia in patients with C-SCI. Methods: The presence and severity of dysphagia in patients with C-SCI was evaluated using a modified videofluoroscopic dysphagia scale (mVDS) and penetration–aspiration scale (PAS). All included patients with C-SCI performed a video fluoroscopic swallowing study (VFSS). Clinical factors such as age, sex, the presence of tracheostomy, spinal cord independence measure (SCIM), pulmonary function test (PFT), including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP), American Spinal Cord Injury Association (ASIA) score, Berg Balance Scale (BBS), and operation method were investigated. Results: In the multivariate regression analysis, the anterior surgical approach was the only clinical factor that had a significant correlation in both mVDS and PAS, which represents the severity of dysphagia in C-SCI patients (p < 0.05). Conclusion: The anterior surgical approach was correlated with the severity of dysphagia in patients with C-SCI. Considering this, as one of the risk factors affecting dysphagia in patients with C-SCI, surgical method may also need to be considered. Additionally, we recommend that clinicians should pay particular attention to the potential for development of dysphagia in patients who received anterior cervical surgery. However, further prospective studies with larger sample sizes are needed for more accurate generalization.

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Alterations in Swallowing Six Weeks After Primary Anterior Cervical Discectomy and Fusion (ACDF)

Jones-Rastelli,

Amin,

Balou

et al. 2023

Dysphagia

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Characterization of dysphagia following anterior cervical spine surgery

Cited by 4 publications

References 35 publications

A scoping review of the methods used to capture dysphagia after anterior cervical discectomy and fusion: the need for a paradigm shift

A scoping review of the methods used to capture dysphagia after anterior cervical discectomy and fusion: the need for a paradigm shift

Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury

Alterations in Swallowing Six Weeks After Primary Anterior Cervical Discectomy and Fusion (ACDF)

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