title: Effect of anterior cervical osteophyte in poststroke dysphagia: a case-control study.
abstract: OBJECTIVE
  To investigate whether the concomitant presence of anterior cervical osteophytes can influence the severity and outcome of patients with poststroke dysphagia.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Hospital.
  
  
  METHODS
  A total of 40 participants were identified (N=40). Patients with poststroke dysphagia with anterior cervical osteophytes (n=20) were identified and matched by age, sex, location, and laterality of the stroke lesion to a poststroke dysphagia control group with no anterior cervical osteophytes (n=20).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Videofluoroscopic swallowing study, Functional Oral Intake Scale (FOIS), and Penetration-Aspiration Scale results assessed within the first month of stroke were analyzed. The FOIS at 6 months was recorded, and severity of dysphagia was compared between the 2 groups.
  
  
  RESULTS
  The case group had larger degrees of postswallow residues in the valleculae and pyriform sinuses (P=.020 and P<.001, respectively), with more patients showing postswallow aspiration (62.5%) than the control group (0%; P<.001), along with a higher risk of being on enteral nutrition feeding (odds ratio [OR]=13.933; 95% confidence interval [CI], 2.863-infinity) within the first month of stroke. At the 6-month follow-up, the case group had significantly lower mean FOIS scores (3.8±1.7) than the control group (6.1±1.3; P<.001), with an increased risk of having persistent dysphagia (OR=15.375; 95% CI, 3.195-infinity).
  
  
  CONCLUSIONS
  The presence of anterior cervical osteophytes, which may cause mechanical obstruction and interfere with residue clearance at the valleculae and pyriform sinuses and result in more postswallow aspiration, may influence initial severity and outcome of poststroke dysphagia. The presence of anterior cervical osteophytes may be considered an important clinical condition that may affect poststroke dysphagia rehabilitation.
authors.affiliation: Department of Rehabilitation Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Youngkook
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Republic of Korea.
authors.forename: Geun-Young
authors.initials: GY
authors.lastname: Park
authors.affiliation: Department of Rehabilitation Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Yu Jung
authors.initials: YJ
authors.lastname: Seo
authors.affiliation: Department of Rehabilitation Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Republic of Korea. Electronic address: lafoliamd@gmail.com.
authors.forename: Sun
authors.initials: S
authors.lastname: Im
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D014741:Video Recording
keywords: Deglutition disorders; Enteral nutrition; Osteophyte; Rehabilitation; Spine; Stroke