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  4. Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury

Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury

J. Clin. Med., 2023 · DOI: 10.3390/jcm12093227 · Published: April 30, 2023

Spinal Cord InjurySurgeryRehabilitation

Simple Explanation

This study looks at risk factors for swallowing problems (dysphagia) in people with cervical spinal cord injuries (C-SCI). It specifically investigates if the type of surgery, either from the front (anterior) or back (posterior) of the neck, is linked to how severe the swallowing problems are. The study found that patients who had surgery from the front of their neck were more likely to have more severe swallowing problems. This suggests that doctors need to be extra careful about swallowing issues in patients who have this type of surgery. The researchers recommend that clinicians should pay particular attention to the potential for development of dysphagia when patients receive anterior cervical surgery.

Study Duration
January 2016 and August 2022
Participants
56 patients with C-SCI
Evidence Level
Not specified

Key Findings

  • 1
    The anterior surgical approach was significantly correlated with the severity of dysphagia in patients with C-SCI, as measured by both mVDS and PAS scales.
  • 2
    Patients undergoing the anterior surgical approach had significantly more severe dysphagia compared to those undergoing the posterior approach.
  • 3
    Other factors previously linked to dysphagia presence, such as tracheostomy, pulmonary function, and age, did not show significant correlations with dysphagia severity in this study.

Research Summary

This study investigated the correlation between surgical approach (anterior vs. posterior) and the severity of dysphagia in patients with cervical spinal cord injury (C-SCI). The key finding was that the anterior surgical approach was significantly associated with increased dysphagia severity, as measured by the modified videofluoroscopic dysphagia scale (mVDS) and penetration–aspiration scale (PAS). The authors suggest that clinicians should be particularly vigilant for dysphagia development in C-SCI patients undergoing anterior cervical surgery and that surgical methods should be considered as a risk factor.

Practical Implications

Surgical Planning

Surgeons should consider the potential for increased dysphagia when choosing between anterior and posterior surgical approaches for C-SCI patients.

Post-operative Monitoring

Clinicians should closely monitor swallowing function in C-SCI patients who have undergone anterior cervical surgery.

Rehabilitation Strategies

Targeted rehabilitation strategies for dysphagia should be implemented early in C-SCI patients post-anterior cervical surgery.

Study Limitations

  • 1
    Retrospective study design in a single tertiary university hospital.
  • 2
    Relatively small sample size, particularly in the anterior approach group.
  • 3
    Inconsistent duration of the interval between surgery and VFSS.

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