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

(2 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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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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The Impact of Cervical Spinal Disease on Pharyngeal Swallowing Function

Walters

Gudipudi

Davidson

et al. 2023

Am J Speech Lang Pathol

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Purpose: Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs). Method: A retrospective case–control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration–Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal–Wallis one-way analysis of variance. Results: Most patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups. Conclusions: Spinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time.

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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

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

The Impact of Cervical Spinal Disease on Pharyngeal Swallowing Function

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