Tracheal traction exercise reduces the occurrence of postoperative dysphagia after anterior cervical spine surgery.
METHODS
We designed a novel anterior cervical spine surgery preoperative treatment comprising mechanical trachea/esophagus traction and compared the postoperative outcome regarding dysphagia with nontreated patients.


OBJECTIVE
We investigated whether the newly developed preoperative tracheal/esophageal traction exercise (TTE) treatment has an effect on postoperative dysphagia after anterior cervical spine surgery.


BACKGROUND
Dysphagia is a postoperative complication that occurs after anterior cervical spine surgery, and known treatments are perioperative application of methylprednisolone, monitoring of endotracheal tube cuff pressure, and the use of low-profile plates. METHODS.: We compared the neck disability index, visual analogue scale scores for arm and neck pain, and Bazaz dysphagia scores, a dysphagia index, of 2 randomized groups, 1 week, 3 weeks, 6 weeks, 3 months, and 6 months after cervical spine surgery. One group received TTE treatment for 3 consecutive days before surgery, whereas the control group did not. RESULTS.: In the first week after operation, the Bazaz dysphagia scores for patients with second- to fourth-level fusions in the TTE group were significantly better than that in the control group (P = 0.000 for second- and third-level fusions and P = 0.013 for fourth-level fusion). Also at 3 weeks after surgery, the second- to fourth-level fusion patients in the TTE group had better Bazaz scores than those in the control group (P = 0.000 for second- and third-level fusions and P = 0.004 for fourth-level fusion). There was no significant difference of neck disability index and visual analogue scale scores between the 2 groups.


CONCLUSIONS
Dysphagia could be reduced in patients with multiple-level fusion after anterior cervical spine surgery by preoperative TTE treatment.
Department of Orthopedics, Shanghai Changhai Hospital, Shanghai, China.
Zhi
Z
Chen
Xianzhao
X
Wei
Fengning
F
Li
Ping
P
He
Xuan
X
Huang
Fan
F
Zhang
Ke
K
Qi
Xinwei
X
Liu
Hongxing
H
Shen
Tiesheng
T
Hou
K Daniel
KD
Riew
D016025:Bone Transplantation / Q000379:methods; D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000517:prevention & control*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D013123:Spinal Fusion / Q000379:methods; D014132:Trachea / Q000503:physiopathology*; D014143:Traction / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome