XXXX following cervical spine surgery with anterior instrumentation: evidence from fluoroscopic swallow studies.

@entity1 @entity13587 @entity4 @entity1282 @entity1173
STUDY DESIGN: Retrospective review. OBJECTIVE: The purpose of this study was to evaluate alterations in objective swallowing parameters in @entity1 reporting @entity1282 after anterior cervical-spine surgery. SUMMARY OF BACKGROUND DATA: @entity1282 is increasingly recognized as a potential complication of anterior surgical approaches to the cervical spine. Retraction pressure on the esophagus that alters blood flow, @entity4 of the pharynx, and @entity13587 are among factors implicated. There has been little investigation of the biomechanics of swallowing in a large cohort of @entity1 reporting postoperative @entity1282 . METHODS: The fluoroscopic swallow studies of all @entity1 reporting @entity1282 after anterior c-spine surgery between January 1, 2000, and December 31, 2008, were retrospectively reviewed. The dysphagic cohort was divided into early (<2 months postsurgery) and late (>2 months) groups. @entity1173 and completeness of epiglottic inversion were noted. Objective measures of pharyngeal wall thickness, upper esophageal sphincter opening, hyoid displacement, pharyngeal constriction, and pharyngeal transit time were abstracted and compared to the same parameters in age and sex-matched normal control subjects. Analysis of variance was used for statistical comparison of objective measures across groups. RESULTS: Sixty-seven @entity1 were identified. Significant differences were identified between control subjects and both @entity1 groups, as well as between the 2 @entity1 groups, for most objective measures considered. Instances of @entity1173 were identified in 50% of @entity1 in the early postoperative group, reduced to 18% in the later group. Significantly increased pharyngeal wall thickness and poor epiglottic inversion were characteristic of both c-spine groups. CONCLUSION: Significant alterations in swallowing mechanics can accompany c-spine surgery with anterior plating. A number of these changes improve over time, leaving @entity1 with relatively minor impairment; however, some appear to be long-lasting. Education and @entity1282 therapy can be useful treatment adjuncts.
