PMID- 32500729
OWN - NLM
STAT- MEDLINE
DCOM- 20201116
LR  - 20220418
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 129
IP  - 11
DP  - 2020 Nov
TI  - Fluoroscopic Swallowing Abnormalities in Dysphagic Patients Following Anterior 
      Cervical Spine Surgery.
PG  - 1101-1109
LID - 10.1177/0003489420929046 [doi]
AB  - OBJECTIVES: To evaluate the precise objective fluoroscopic abnormalities in 
      persons with dysphagia following anterior cervical spine surgery (ACSS). METHODS: 
      129 patients with dysphagia after ACSS were age and sex matched to 129 healthy 
      controls. All individuals underwent videofluoroscopic swallow study (VFSS). VFSS 
      parameters abstracted included upper esophageal sphincter (UES) opening, 
      penetration aspiration scale (PAS), and pharyngeal constriction ratio (PCR). 
      Other data collected included patient-reported outcome measures of voice and 
      swallowing, number of levels fused, type of plate, vocal fold immobility, time 
      from surgery to VFSS, and revision surgery status. RESULTS: The mean age of the 
      entire cohort was 63 (SD +/- 11) years. The mean number of levels fused was 2.2 
      (+/-0.9). 11.6% (15/129) were revision surgeries. The mean time from ACSS to VFSS 
      was 58.3 months (+/-63.2). The majority of patients (72.9%) had anterior cervical 
      discectomy and fusion (ACDF). For persons with dysphagia after ACSS, 7.8% 
      (10/129) had endoscopic evidence of vocal fold immobility. The mean UES opening 
      was 0.84 (+/-0.23) cm for patients after ACSS and 0.86 (+/-0.22) cm for controls (P > 
      .0125). Mean PCR was 0.12 (+/-0.12) for persons after ACSS and 0.08 (+/-0.08) for 
      controls, indicating significant post-surgical pharyngeal weakness (P < .0125). 
      The median PAS was 1 (IQR 1) for persons after ACSS as well as for controls. For 
      ACSS patients, PCR had a weak correlation with EAT-10 (P < .0125). CONCLUSION: 
      Chronic swallowing dysfunction after ACSS appears to be secondary to pharyngeal 
      weakness and not diminished UES opening, the presence of aspiration, vocal fold 
      immobility, or ACSS instrumentation factors.Level of Evidence: 3b.
FAU - Ian Dhar, Shumon
AU  - Ian Dhar S
AUID- ORCID: 0000-0001-9873-8641
AD  - Johns Hopkins University, Department of Otolaryngology-Head and Neck Surgery, 
      Baltimore, MD.
FAU - Wegner, Adam M
AU  - Wegner AM
AUID- ORCID: 0000-0001-5862-800X
AD  - Washington University in Saint Louis, Department of Orthopedic Surgery, Saint 
      Louis, MO, USA.
FAU - Rodnoi, Pope
AU  - Rodnoi P
AD  - University of California Davis, Department of Orthopaedic Surgery, Sacramento, 
      CA, USA.
FAU - Wuellner, John C
AU  - Wuellner JC
AD  - University of California Davis, Department of Orthopaedic Surgery, Sacramento, 
      CA, USA.
FAU - Mehdizadeh, Omid Benjamin
AU  - Mehdizadeh OB
AD  - University of California Davis, Department of Otolaryngology-Head and Neck 
      Surgery, Sacramento, CA.
FAU - Shen, Shih C
AU  - Shen SC
AD  - University of California Davis, Department of Otolaryngology-Head and Neck 
      Surgery, Sacramento, CA.
AD  - Chang Gung Memorial Hospital Department of Otolaryngology-Head and Neck Surgery, 
      Linkou.
FAU - Nachalon, Yuval
AU  - Nachalon Y
AD  - University of California Davis, Department of Otolaryngology-Head and Neck 
      Surgery, Sacramento, CA.
FAU - Nativ-Zeltzer, Nogah
AU  - Nativ-Zeltzer N
AD  - University of California Davis, Department of Otolaryngology-Head and Neck 
      Surgery, Sacramento, CA.
FAU - Belafsky, Peter C
AU  - Belafsky PC
AD  - University of California Davis, Department of Otolaryngology-Head and Neck 
      Surgery, Sacramento, CA.
FAU - Klineberg, Eric O
AU  - Klineberg EO
AD  - University of California Davis, Department of Orthopaedic Surgery, Sacramento, 
      CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20200605
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
SB  - IM
MH  - Case-Control Studies
MH  - Cervical Vertebrae
MH  - Deglutition/*physiology
MH  - Deglutition Disorders/*diagnosis/etiology/physiopathology
MH  - Esophageal Sphincter, Lower/*diagnostic imaging/physiopathology
MH  - Female
MH  - Fluoroscopy/*methods
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures/*adverse effects
MH  - Postoperative Complications/*diagnosis/etiology/physiopathology
MH  - Retrospective Studies
MH  - Spinal Diseases/*surgery
OTO - NOTNLM
OT  - anterior spine surgery
OT  - dysphagia
OT  - fluoroscopy
OT  - swallowing
OT  - upper esophageal sphincter
EDAT- 2020/06/06 06:00
MHDA- 2020/11/18 06:00
CRDT- 2020/06/06 06:00
PHST- 2020/06/06 06:00 [pubmed]
PHST- 2020/11/18 06:00 [medline]
PHST- 2020/06/06 06:00 [entrez]
AID - 10.1177/0003489420929046 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2020 Nov;129(11):1101-1109. doi: 
      10.1177/0003489420929046. Epub 2020 Jun 5.