Two Cases of Dysphagia as a Secondary Postoperative Complication after Anterior Cervical Spine Fusion
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Dysphagia frequently presents in patients with a cervical spinal cord injury following anterior cervical spine fusion (ACSF). However, it is essential to identify the cause of dysphagia because it can occur due to a variety of reasons, such as structural lesions, psychiatric problems, as well as neurologic impairment. We report two cases of dysphagia as secondary postoperative complications after ACSF. The first case was a 60-year-old male who experienced pain while swallowing, having undergone C3/4 ACSF due to traumatic retrolisthesis at C3/4. A videofluoroscopic swallowing study (VFSS) demonstrated a delayed swallowing reflex and liquid penetration. A cervical spine magnetic resonance imaging (MRI) showed a deep neck infection at the C4-7 level. Following intravenous antibiotic administration, the patient’s pain significantly improved. The second case was that of a 74-year-old female who underwent C3/4 ACSF due to an accidental fall. A VFSS demonstrated post-swallowing liquid aspiration. However, she complained of a foreign sensation in the throat and aspiration. A cervical spine computed tomography (CT) showed a suspected hardware loosening, which interfered with the passage of food. In patients with a cervical spinal cord injury, mechanical problems related to the surgery can be a cause of swallowing difficulty. Prompt identification and treatment of these complications are essential for patient recovery.
Abstract
Dysphagia frequently presents in patients with a cervical spinal cord injury following anterior cervical spine fusion (ACSF). However, it is essential to identify the cause of dysphagia because it can occur due to a variety of reasons, such as structural lesions, psychiatric problems, as well as neurologic impairment. We report two cases of dysphagia as secondary postoperative complications after ACSF. The first case was a 60-year-old male who experienced pain while swallowing, having undergone C3/4 ACSF due to traumatic retrolisthesis at C3/4. A videofluoroscopic swallowing study (VFSS) demonstrated a delayed swallowing reflex and liquid penetration. A cervical spine magnetic resonance imaging (MRI) showed a deep neck infection at the C4-7 level. Following intravenous antibiotic administration, the patient’s pain significantly improved. The second case was that of a 74-year-old female who underwent C3/4 ACSF due to an accidental fall. A VFSS demonstrated post-swallowing liquid aspiration. However, she complained of a foreign sensation in the throat and aspiration. A cervical spine computed tomography (CT) showed a suspected hardware loosening, which interfered with the passage of food. In patients with a cervical spinal cord injury, mechanical problems related to the surgery can be a cause of swallowing difficulty. Prompt identification and treatment of these complications are essential for patient recovery.
참고문헌 (20)
- Kirshblum S, "Predictors of dysphagia after spinal cord injury", Arch Phys Med Rehabil, 80, pp.1101~1105 (1999)[DOI]
- Hayashi T, "Risk factors for severe dysphagia in acute cervical spinal cord injury", Spinal Cord, 55, pp.940~943 (2017)[DOI]
- McRae J, "Oropharyngeal dysphagia in acute cervical spinal cord injury : a literature review", Dysphagia, 38, pp.1025~1038 (2023)[DOI]
- Rofes L, "Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly", Gastroenterol Res Pract, 2011, pp.818979~ (2011)[DOI]
- Ekberg O, "Social and psychological burden of dysphagia : its impact on diagnosis and treatment", Dysphagia, 17, pp.139~146 (2002)[DOI]
- Savic G, "Causes of death after traumatic spinal cord injury-a 70-year British study", Spinal Cord, 55, pp.891~897 (2017)[DOI]
- Grundy DJ, "Cranial nerve palsies in cervical injuries", Spine(Phila Pa 1976), 9, pp.339~343 (1984)[DOI]
- Yee TJ, "Complications of anterior cervical spine surgery : a systematic review of the literature", J Spine Surg, 6, pp.302~322 (2020)[DOI]
- Kii Y, "Rehabilitation approaches to dysphagia that was developed for a patient who attempted to commit suicide by hanging : a case report", Eur J Phys Rehabil Med, 50, pp.185~188 (2014)
- Kim YS, "Clinical evaluation of salvage surgery for patients with failed anterior cervical surgery", J Korean Neurosurg Soc, 26, pp.113~118 (1997)
- Tsalimas G, "Dysphagia as a postoperative complication of anterior cervical discectomy and fusion", Cureus, 14, pp.e26888~ (2022)[DOI]
- Bazaz R, "Incidence of dysphagia after anterior cervical spine surgery : a prospective study", Spine(Phila Pa 1976), 27, pp.2453~2458 (2002)[DOI]
- Lee MJ, "Risk factors for dysphagia after anterior cervical spine surgery : a two-year prospective cohort study", Spine J, 7, pp.141~147 (2007)[DOI]
- Radcliff KE, "What is the incidence of dysphagia after posterior cervical surgery?", Spine(Phila Pa 1976), 38, pp.1082~1088 (2013)[DOI]
- Fountas KN, "Anterior cervical discectomy and fusion associated complications", Spine(Phila Pa 1976), 32, pp.2310~2317 (2007)[DOI]
- Christiano LD, "Late prevertebral abscess after anterior cervical fusion", Spine(Phila Pa 1976), 36, pp.E798~E802 (2011)[DOI]
- Hendriks T, "Dysphagia due to massive retropharyngeal and pre-vertebral abscess", BMJ Case Rep, 11, pp.e228162~ (2018)[DOI]
- Pompili A, "Asymptomatic esophageal perforation caused by late screw migration after anterior cervical plating : report of a case and review of relevant literature", Spine(Phila Pa 1976), 27, pp.E499~E502 (2002)[DOI]
- Geyer TE, "Oral extrusion of a screw after anterior cervical spine plating", Spine(Phila Pa 1976), 26, pp.1814~1816 (2001)[DOI]
- Kim SW, "Improvement of dysphagia after anterior cervical screw removal : a case report", J Korean Dysphagia Soc, 5, pp.66~70 (2015)