Cooper, Rebecca

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Rowan University

Rowan University Rowan Digital Works Cooper Medical School of Rowan University Capstone Projects Cooper Medical School of Rowan University 2020 Characterization of dysphagia following anterior cervical spine surgery Rebecca Cooper Follow this and additional works at: https://rdw.rowan.edu/cmsru_capstones Let us know how access to this document benefits you - share your thoughts on our feedback form. Recommended Citation Cooper, Rebecca, "Characterization of dysphagia following anterior cervical spine surgery" (2020). Cooper Medical School of Rowan University Capstone Projects. 36. https://rdw.rowan.edu/cmsru_capstones/36 This Poster is brought to you for free and open access by the Cooper Medical School of Rowan University at Rowan Digital Works. It has been accepted for inclusion in Cooper Medical School of Rowan University Capstone Projects by an authorized administrator of Rowan Digital Works. For more information, please contact brush@rowan.edu. Template ID: assessingslate  Size: 48x36Characterization of dysphagia following anterior cervical spine surgeryCooper RL1, Davidson KD1, Garand KG2, Nguyen SA1, Martin-Harris BMH3, O’Rourke AK11MUSC; 2South Alabama; 3Northwestern University❖ Swallowing was objectively impaired in dysphagic patients following ACSS in the early post-op period, but most parameters improved by 2 months. PWT, however, remained increased but did not appear to clinically affect other measured swallowing parameters. ❖ These data agree with other limited studies completed in this patient population and can inform both patients and clinicians regarding recovery expectations.3-6CONCLUSIONSREFERENCESAlthough postoperative dysphagia is well established as a potential complication of anterior cervical spine surgery (ACSS), this important clinical problem remains poorly understood.  The purpose of this investigation was to examine changes in structural and physiologic swallowing measures in patients with dysphagia following ACSS.INTRODUCTIONObjective Swallowing Measures❖ Pharyngeal wall thickness (PWT)❖ Penetration-Aspiration Scale1 (PAS) scores❖ Modified Barium Swallow Impairment Profile2 (MBSImP) metrics Statistical AnalysisStudents T-Test for Independent Means or the Mann-Whitney U test if data failed Shapiro-Wilk normality testing.METHODSVideofluoroscopic swallow studies of patients with dysphagia after ACSS between January 1, 2010 and October 5, 2018, were retrospectively reviewed. Exclusion Criteria: Patients with additional diagnoses and/or known comorbidities associated with dysphagia were excluded from analysis (e.g. stroke, progressive neurologic disease, neuromuscular disease). Early postoperative dysphagia<2 months post-surgeryLate postoperative dysphagia>2 months post-surgeryHealthy, non-dysphagic age- and sex-matched controls❖ Seventy-five patients were included in the study, 41 males and 34 females. The mean age of the early post-op group was 61.5 (range 21-82) years and 40.4% were females. The late post-op group had a mean age of 52.6 (range 29-69) years and 61.1% were females. Fifty-seven patients (76%) had underwent surgery within 2 months and 18 patients (24%) were greater than 2 months post-surgery. ❖ Significant differences were identified for all evaluated parameters between control subjects and the early post-op group, as well as between the early and late patient groups (Table 2). ❖ PWT was significantly greater in the late post-op group compared to controls, however other measures between these groups did not differ significantly.Figure 1. Average PAS Scores Figure 2. Average TPI Scores Figure 3. Average PWT (mm)RESULTSMeasure Group M + SD P-valuePAS Score0a 1.56 + 1.2 0 to 1, P <0.001*1b 5.46 + 2.7 0 to 2, P = 0.5212c 1.56 + 1.7 1 to 2, P <0.001*TPI Score0 5.33 + 2.5 0 to 1, P <0.001*1 11.4 + 4.5 0 to 2, P = 0.0412 4.28 + 5.1 1 to 2, P <0.001*PWT (mm)0 4.72 + 1.3 0 to 1, P <0.001*1 14.2 + 4.5 0 to 2, P <0.001*2 9.36 + 4.0 1 to 2, P <0.001*Abbreviations: PAS, penetration-aspiration scale; TPI, total pharyngeal impairment; PWT, pharyngeal wall thicknessaGroup 0 = controls; bGroup 1 = early postoperative patients (<2 mo);cGroup 2 = late postoperative patients (>2 mo) 1. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A Penetration-aspiration scale. Dysphagia. 1996 Spring;11(2):93-8.2. Martin-Harris B, Brodsky MB, Michel Y, et al. MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard. Dysphagia. 2008;23(4):392-405.3. Martin RE, Neary MA, Diamant NE. Dysphagia following anterior cervical spine surgery. Dysphagia. 1997;12(1):2-8; discussion 9.4. Frempong-Boadu A, Houten JK, Osborn B, et al. Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech. 2002;15(5):362-368 5. Leonard R, Belafsky P. Dysphagia following cervical spine surgery with anterior instrumentation: evidence from fluoroscopic swallow studies. Spine (Phila Pa 1976). 2011;36(25):2217-2223. 6. Muss L, Wilmskoetter J, Richter K, et al. Changes in Swallowing After Anterior Cervical Discectomy and Fusion With Instrumentation: A Presurgical Versus Postsurgical Videofluoroscopic Comparison. Journal of Speech, Language, and Hearing Research. 2017;60(4):785-793. 

Characterization of dysphagia following anterior cervical spine surgery

https://rdw.rowan.edu/cgi/viewcontent.cgi?article=1038&amp;context=cmsru_capstones

Characterization of dysphagia following anterior cervical spine surgery

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