Changes in Swallowing After Anterior Cervical Discectomy and Fusion With Instrumentation: A Presurgical Versus Postsurgical Videofluoroscopic Comparison.
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.



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.



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.



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.
Bielefeld University, Bielefeld, GermanyMedical Park Loipl, Bischofswiesen, Germany.
Lydia
L
Muss
Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, GermanyMedical University of South Carolina, Charleston.
Janina
J
Wilmskoetter
Bielefeld University, Bielefeld, Germany.
Kerstin
K
Richter
Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, GermanyThe Federal Joint Committee, Berlin, Germany.
Constanze
C
Fix
Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, GermanyHospital zum Heiligen Geist Kempen, Kempen, Nordrhein-Westfalen, Germany.
Soenke
S
Stanschus
Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany.
Tobias
T
Pitzen
Stiftung Rehabilitation Heidelberg (SRH; Foundation Rehabilitation Heidelberg) Clinic Karlsbad, Karlsbad, Germany.
Joerg
J
Drumm
University Health Network, Toronto Rehabilitation Institute, CanadaNew York University.
Sonja
S
Molfenter
D000328:Adult; D000368:Aged; D001368:Axis, Cervical Vertebra / Q000601:surgery*; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017586:Diskectomy; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006928:Hyoid Bone / Q000000981:diagnostic imaging / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010614:Pharynx / Q000000981:diagnostic imaging / Q000502:physiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013123:Spinal Fusion; D014741:Video Recording