Dysphagia Secondary to Anterior Cervical Fusion: Radiologic Evaluation and Findings in 74 Patients

Abstract

Dysphagia is an underrecognized but significant complication of ACF. After ACF, 4.1% of patients presented for radiologic evaluation of dysphagia. Although ACF procedures are most frequently performed in the lower cervical spine, dysphagia is a more common clinical problem after ACF in the mid cervical spine. Radiologic examinations should be specifically tailored to evaluate ACF patients.

Influence of prevertebral soft tissue swelling on dysphagia after anterior cervical discectomy and fusion using a rectangular titanium stand-alone cage

“…The incidence of dysphagia within 1 week after anterior cervical spine surgery varies from 1% to 79%. [ 9 13 14 15 16 17 ] This wide variation may be attributed to differences in patient age and sex, surgical technique, extent of surgery, spine level, operative time, or use of spinal instrumentation. Bazaz et al .…”

“…analyzed a radiologic evaluation of modified barium swallow studies and esophagrams in 74 patients who demonstrated dysphagia secondary to ACF. [ 17 ] Serious complications of ACF that resulted in dysphagia included surgical hardware displacement or bone graft displacement, esophageal perforation, and retropharyngeal abscess. Pharyngeal functional abnormalities were detected in 50 patients (67.6%), with penetration, aspiration, or both, seen in 32 patients (43.2%).…”

“…However, oropharyngeal complications after ACDF such as dysphagia, hoarseness, or esophageal perforation may be still underestimated although they have been discussed in the literature. [ 8 9 10 11 12 13 14 15 16 17 18 19 20 21 ] Their frequency, severity, and possible eventual recovery after surgery need to be carefully considered. The purpose of this study is to investigate the incidence, severity, and possible risk factors for postoperative dysphagia recognized within 30 days after 1- or 2-level ACDF using a rectangular titanium stand-alone cage.…”

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

“…The exact cause of dysphagia in the traumatic spinal injury is still unknown as it is often multifactorial. This can include, but is not limited to, soft-tissue swelling, displacement of the esophagus and/or pharynx, damage to critical nerves from retraction and dissection, and hematoma [16, 17]. Sensory deficits as a result of damage to the pharyngeal branch of the vagus nerve or glossopharyngeal nerve may also be implicated due to the observation of silent aspiration and impaired cough reflex within this population [18].…”

Missed diagnosis of oesophageal perforation in ankylosing spondylitis cervical fracture: Two case reports and literature review

“…Contrast oesophagography is the standard diagnostic tool for oesophageal perforation 16 and barium contrast oesophagography should be used if no perforation is detected. 17 , 18 This technique cannot be easily used in patients with cervical spine injury, however. Flexible oesophagoscopy has a sensitivity of 95.8–100% and a specificity of 92.4–100% in the evaluation of penetrating oesophageal injury and can provide a direct visualization of the perforation; it is thought to be a useful diagnostic tool with a good safety profile in the early evaluation of penetrating injuries.…”