Ko Jong-Hyun, Han Kap-Soo, Yoon Sun-Jung
Department of Orthopedic Surgery, Jeonbuk National University Medical School, Jeonju-si 54907, Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju-si 54907, Korea.
J Clin Med. 2022 Apr 28;11(9):2470. doi: 10.3390/jcm11092470.
Dysphagia is the most common complication of anterior cervical discectomy and fusion (ACDF). Several studies have reported dysphagia's incidence, severity, and prognosis after ACDF; however, few have investigated the objective effects of dysphagia management. We aimed to elucidate the efficacy of laryngeal rehabilitation therapy for dysphagia following ACDF. This prospective randomized control trial included 20 patients who underwent more than two-level ACDF. Laryngeal rehabilitation therapy was performed on 10 patients for 7 days, whereas the remaining 10 comprised the control group. Pharyngeal transit time (PTT) by videofluoroscopic swallowing study (VFSS) was performed to evaluate the objective state of swallowing. We analyzed Bazaz scale and total variance of prevertebral soft tissue swelling (PSTS) from C2 to C7 on lateral cervical radiographs during hospitalization and at 4 and 8 weeks post-surgery. The PTT of the rehabilitation group was shorter than that of the control group at 7 days and 4 weeks post-surgery (-value; POD 7D = 0.003, POD 4W = 0.042, POD 8W = 0.097). Perioperative laryngeal rehabilitation therapy effectively reduces postoperative dysphagia after ACDF.
吞咽困难是颈椎前路椎间盘切除融合术（ACDF）最常见的并发症。多项研究报告了ACDF后吞咽困难的发生率、严重程度和预后；然而，很少有研究调查吞咽困难管理的客观效果。我们旨在阐明喉康复治疗对ACDF后吞咽困难的疗效。这项前瞻性随机对照试验纳入了20例行两级以上ACDF的患者。10例患者接受了为期7天的喉康复治疗，其余10例为对照组。通过电视荧光吞咽造影检查（VFSS）测量咽传输时间（PTT），以评估吞咽的客观状态。我们分析了住院期间以及术后第4周和第8周颈椎侧位X线片上从C2至C7椎体前方软组织肿胀（PSTS）的Bazaz量表和总方差。康复组术后第7天和第4周的PTT短于对照组（-值；术后第7天=0.003，术后第4周=0.042，术后第8周=0.097）。围手术期喉康复治疗可有效减轻ACDF术后的吞咽困难。
