Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Department of Neurosurgery, Emory University Hospital, Atlanta, Georgia, USA.
World Neurosurg. 2020 May;137:146-148. doi: 10.1016/j.wneu.2020.01.180. Epub 2020 Feb 7.
Anterior cervical spine surgeries have low morbidity, sufficient surgical corridor, and quick recovery times. Although largely considered a safe and effective procedure to address cervical myelopathy, radiculopathy, and deformity, dysphagia is a frequent yet poorly understood adverse event. One treatment is cricopharyngeal myotomy (CPM), which aids in swallowing for patients with refractory issues after anterior cervical decompression and fusion (ACDF).
Here we describe our experience with 6 patients requiring revision ACDF with preoperative dysphagia who were treated with concurrent revision and CPM. Our series demonstrated that CPM is an effective and safe procedure used in combination with an ACDF. In our series, we had 6 patients with dysphagia preoperatively who were all able to undergo ACDF without worsening of their dysphagia despite having risk factors predisposing them to this complication. In our series, 83% of patients either improved or experienced resolution of their symptoms with only 1 patient failing to improve.
Given its efficacy and safety, patients planned for ACDF with preoperative dysphagia should be evaluated by ENT for potential CPM.
颈椎前路手术具有发病率低、手术通道充足和恢复时间快的特点。尽管颈椎前路减压融合术（ACDF）被广泛认为是一种安全有效的治疗颈椎病、神经根病和畸形的方法，但吞咽困难是一种常见但尚未被充分了解的不良事件。一种治疗方法是环咽肌切开术（CPM），它可以帮助吞咽困难的患者在接受颈椎前路减压和融合术（ACDF）后解决难治性问题。
在这里，我们描述了我们对 6 例术前有吞咽困难的患者进行 ACDF 翻修并同时进行 CPM 的经验。我们的研究表明，CPM 是一种与 ACDF 联合使用的有效且安全的手术。在我们的研究中，有 6 例术前有吞咽困难的患者，尽管存在导致这种并发症的危险因素，但他们都能够接受 ACDF 手术，而不会使吞咽困难恶化。在我们的研究中，83%的患者的症状得到改善或缓解，只有 1 例患者没有改善。
鉴于其疗效和安全性，对于术前有吞咽困难计划进行 ACDF 的患者，耳鼻喉科医生应评估是否需要进行潜在的 CPM。
