Dysphagia Associated with Cervical Spine Disorders

Weinshel, Steven S.; Maiman, Dennis J.; Mueller, Wade

doi:10.1097/00002517-198800140-00007

Cited by 10 publications

(7 citation statements)

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“…Similarly, in the studies of DISHinduced dysphagia reported by Stuart [1], McCafferty et al [7], and Weinshel et al [18], some patients required several months to recover. The early resolution of symptoms might be a result of eliminating the mechanical obstruction of the esophagus.…”

Section: Discussionmentioning

confidence: 82%

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

et al. 2009

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Although cervical anterior osteophytes accompanying diffuse idiopathic skeletal hyperostosis (DISH) are generally asymptomatic, large osteophytes sometimes cause swallowing disorders. Surgical resection of the osteophyte has been reported to be an effective treatment; however, little study has been given to the recurrences of osteophytes. A prospective study was performed for seven patients who underwent surgical resection of cervical anterior osteophytes for the treatment of recalcitrant dysphagia caused by osteophytes that accompanied DISH. The seven patients were six men and one woman ranging in age from 55 to 78 years (mean age = 65 years). After a mean postoperative follow-up period of 9 years (range: 6-13 years), surgical outcomes were evaluated by symptom severity and plain radiographs of the cervical spine. On all operated intervertebral segments, the effect of postoperative intervertebral mobility (range of movement[1 degree) on the incidence of recurrent osteophytic formation (width [2 mm) was analyzed by Fisher's exact test. Complete relief of the dysphagia was obtained within one month postoperatively in five patients, while it was delayed for 3 months in two patients.All of the patients developed recurrent cervical osteophytic formation, with an average increase rate of approximately 1 mm/year following surgical resection. Of the 20 operated intervertebral segments, the incidence of recurrent osteophytes was significantly higher (P = 0.0013) in the 16 segments with mobility than in the four segments without mobility. Five of the seven patients remained asymptomatic, although radiological recurrence of osteophytes was seen at the final follow-up. The two remaining patients complained of moderate dysphagia 10 and 11 years after surgery, respectively; one of these two required re-operation due to progressive dysphagia 11 years postoperatively. In patients with cervical DISH and dysphagia, surgical resection of osteophytes resulted in a high likelihood of the recurrence of osteophytes. Therefore, attending surgeons should continue to follow these patients postoperatively for more than 10 years in order to assess the regrowth of osteophytes that may contribute to recurrent symptoms.

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Section: Discussionmentioning

confidence: 82%

Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis

et al. 2009

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“…However, there had been reports that linked dysphagia to a number of predictors for dysphagia such as age [24], anterior surgery to the spine [1][2][3][4][5][6][25][26][27][28][29], tracheostomy [9,21,30,31], and prolonged oral or nasal intubation [7,9,23,32]. Also, there had been reports about mechanical obstacles impairing deglutition, e.g., osteophytes, hematoma [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. No reports were available concerning the impact of the level of SCI or outcome or frequency of complications.…”

Section: Predisposing Factorsmentioning

confidence: 99%

Cervical Spinal Cord Injury and Deglutition Disorders

2004

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The association of cervical spinal cord injury and swallowing disorders is clinically well recognized. This study was performed to determine the clinical significance and the outcome of deglutition disorders observed in the initial treatment of cervical spinal cord injury in our tertiary care spinal cord injury unit. All patients with cervical spinal cord injury admitted to our facility for initial care between January 1997 and December 2000 were included in our study. Prevalence of dysphagia and frequency of pneumonia were determined. An assessment of deglutition at discharge was performed. Dysphagia was diagnosed in 26 of the 73 patients with cervical spinal cord injury. Tracheostomy and duration of orotracheal intubation are associated with dysphagia. The disorder necessitated dietary restrictions in 18 patients. Six of these patients had to be discharged with a percutaneous enterogastric feeding tube; seven had persistent problems not resulting in dietary restrictions. The incidence of late pneumonia was significantly increased with two associated deaths. Dysphagia is a serious complication associated with prolonged requirement for ventilatory support. Patients have to be monitored closely because the incidence of pneumonia is increased. While the situation improves for most patients, a significant number of patients need a percutaneous enterogastric feeding tube as a permanent solution.

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“…Dysphagia and, less often, dysphonia caused by osteophytic spurring of the anterior cervical spine have been described sporadically in the otolaryngologic and neurosurgical literature, [2][3][4][5] but the causal relationship between anterior cervical osteophytes and dysphagia has not been clearly established. 6,7 Because the incidences of both dysphagia and cervical spondylosis increase with advancing age, the two may coexist, posing a diagnostic and therapeutic dilemma.…”

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confidence: 99%