Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review

Dysphagia, 2023 · DOI: https://doi.org/10.1007/s00455-022-10535-0 · Published: November 14, 2022

Simple Explanation

Dysphagia, or swallowing impairment, is a common issue following cervical spinal cord injury (cSCI). This review summarizes current understanding of dysphagia in cSCI patients. The review aims to summarize the literature on the risk factors, presentation, assessment, and management of dysphagia in patients with cSCI. A bespoke approach to dysphagia management, that accounts for the multiple system impairment in cSCI, is presented; the overarching aim of which is to support effective management of dysphagia in patients with cSCI to prevent adverse clinical consequences.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Dysphagia in cSCI can stem directly from the neural injury, subsequent interventions like surgeries, or post-surgical complications.
2
Respiratory muscle dysfunction, common in cSCI, disrupts the crucial respiratory-swallowing coordination needed for airway protection.
3
Esophageal impairments are frequently under-reported in cSCI patients and can significantly impact swallowing safety and efficiency.

Research Summary

Dysphagia is a common complication following cervical spinal cord injury (cSCI) with life-threatening consequences, including aspiration pneumonia. The causes of dysphagia in cSCI are multifactorial, including nerve damage, surgical consequences, respiratory muscle dysfunction, and esophageal impairment. Management of dysphagia in cSCI requires a multidisciplinary approach, including early detection, instrumental assessment, and tailored rehabilitation strategies.

Practical Implications

Early Dysphagia Screening

Implement routine dysphagia screening for cSCI patients to prevent aspiration pneumonia.

Personalized Treatment Plans

Develop tailored rehabilitation programs based on instrumental assessments to address specific swallowing impairments.

Multidisciplinary Care

Ensure a consistent multidisciplinary team approach to dysphagia management, including SLPs with specialist skills.

Study Limitations

1
Studies mainly evaluate patients in specialist spinal cord injury units, excluding those with comorbidities.
2
Some studies focus on either elective spinal surgeries or traumatic injuries, impacting risk factor analysis.
3
Diagnosis of dysphagia varies based on evaluation method and assessor expertise, affecting prevalence rates.

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