Changes in Swallowing After Anterior Cervical Discectomy and Fusion With Instrumentation: A Presurgical Versus Postsurgical Videofluoroscopic Comparison Purpose The purpose of this study was to explore the impact of anterior cervical discectomy and fusion (ACDF) with anterior instrumentation on swallowing function and physiology as measured on videofluoroscopic swallowing studies. Method We retrospectively analyzed both functional measures (penetration-aspiration, residue) and physiological/anatomical measures (hyoid excursion, posterior pharyngeal ... Research Article
Research Article  |   April 14, 2017
Changes in Swallowing After Anterior Cervical Discectomy and Fusion With Instrumentation: A Presurgical Versus Postsurgical Videofluoroscopic Comparison
 
Author Affiliations & Notes
  • Lydia Muss
    Bielefeld University, Bielefeld, Germany
    Medical Park Loipl, Bischofswiesen, Germany
  • Janina Wilmskoetter
    Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany
    Medical University of South Carolina, Charleston
  • Kerstin Richter
    Bielefeld University, Bielefeld, Germany
  • Constanze Fix
    Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany
    The Federal Joint Committee, Berlin, Germany
  • Soenke Stanschus
    Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany
    Hospital zum Heiligen Geist Kempen, Kempen, Nordrhein-Westfalen, Germany
  • Tobias Pitzen
    Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany
  • Joerg Drumm
    Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany
  • Sonja Molfenter
    University Health Network, Toronto Rehabilitation Institute, Canada
    New York University
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Lydia Muss: lydiamuss15@gmail.com
  • Editor: Julie Liss
    Editor: Julie Liss×
  • Associate Editor: Catriona Steele
    Associate Editor: Catriona Steele×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Speech / Research Articles
Research Article   |   April 14, 2017
Changes in Swallowing After Anterior Cervical Discectomy and Fusion With Instrumentation: A Presurgical Versus Postsurgical Videofluoroscopic Comparison
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, 785-793. doi:10.1044/2016_JSLHR-S-16-0091
History: Received March 7, 2016 , Revised June 21, 2016 , Accepted August 7, 2016
 
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, 785-793. doi:10.1044/2016_JSLHR-S-16-0091
History: Received March 7, 2016; Revised June 21, 2016; Accepted August 7, 2016

Purpose The purpose of this study was to explore the impact of anterior cervical discectomy and fusion (ACDF) with anterior instrumentation on swallowing function and physiology as measured on videofluoroscopic swallowing studies.

Method We retrospectively analyzed both functional measures (penetration-aspiration, residue) and physiological/anatomical measures (hyoid excursion, posterior pharyngeal wall thickness) in a series of 17 patients (8 men, 9 women, mean age 54 years). These measures were extracted from calibrated 5-ml boluses of thin radio-opaque liquids on both pre-ACDF and post-ACDF videofluoroscopies, thus controlling for individual variation and protocol variation.

Results After ACDF surgery, we found significant within-subject worsening of Penetration-Aspiration Scale (Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996) scores, vallecular (but not piriform sinus) residue, superior (but not anterior) hyoid excursion, and posterior pharyngeal wall thickness. Results are discussed in the context of previous literature.

Conclusions ACDF surgery can affect both physiological/anatomical and functional measures of swallowing. Future research should expand to other biomechanical and temporal variables, as well as greater bolus volumes and a wider array of viscosities and textures.

Acknowledgments
We would like to thank Catriona Steele and Melanie Péladeau-Pigeon of the University Health Network in Toronto, Canada, for their contributions in developing the modified hyoid measurement method for spine surgery patients.
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