Role of O-C2 angle in the development of dysphagia in patients with halo-vest fixation

BMC Musculoskeletal Disorders, 2020 · DOI: https://doi.org/10.1186/s12891-020-3155-2 · Published: February 21, 2020

Simple Explanation

This study investigates the relationship between cervical alignment, specifically the O-C2 angle, and the development of dysphagia in patients treated with halo-vest braces. The study found that a smaller O-C2 angle is associated with a higher incidence and severity of dysphagia in these patients. Additionally, longer stays in the intensive care unit (ICU) and lower body mass index (BMI) were identified as independent risk factors for dysphagia in this population.

Study Duration

January 2006 and August 2016

Participants

41 patients who had undergone halo-vest fixation

Evidence Level

Not specified

Key Findings

1
O-C2 angle was significantly smaller in patients who developed dysphagia during halo-vest fixation.
2
BMI, ICU stay, and O-C2 angle were independent risk factors for dysphagia in patients with halo-vest fixation.
3
Smaller O-C2 angle and longer ICU stay were associated with lower FILS.

Research Summary

This study aimed to elucidate the relationship between cervical alignment and incidence of dysphagia in patients treated with a halo-vest brace by evaluating lateral radiological findings of the cervical spine, as well as patient clinical data from medical charts. The study found that O-C2 angle is related to both incidence and severity of dysphagia due to halo-vest fixation. The results suggest that inadequate extension at O-C2 may contribute to swallowing difficulties in patients with halo-vest fixation.

Practical Implications

Clinical Positioning

At the time of halo-vest assembly, lateral cervical spine X-ray including the skull to ensure an adequate O-C2 angle may be helpful in finding the best position to allow normal swallowing in patients with halo-vest fixation.

Risk Factor Identification

ICU stay, BMI, and O-C2 angle were identified as independent risk factors for dysphagia, highlighting the importance of monitoring these factors in patients with halo-vest fixation.

Swallowing Function

Smaller O-C2 angle and longer ICU stay were associated with lower FILS, suggesting that intervention strategies should be focused on improving swallowing function in these patients.

Study Limitations

1
Retrospective study design.
2
Fiberoptic endoscopic and/or video-fluoroscopic swallow studies were not performed for every patient.
3
Lack of radiographic data before halo-vest fixation.

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