Ann Rehabil Med.  2019 Feb;43(1):27-37. 10.5535/arm.2019.43.1.27.

Characteristics and Clinical Course of Dysphagia Caused by Anterior Cervical Osteophyte

• Choi HE
• Jo GY
• Kim WJ
• Do HK
• Kwon JK
• Park SH

• KMID: 2440949
• DOI: http://doi.org/10.5535/arm.2019.43.1.27

Abstract

OBJECTIVE
To investigate swallowing characteristics of patients with dysphagia caused by anterior cervical osteophytes (ACOs) and compare clinical courses according to treatment options.
METHODS
A retrospective analysis of 1,866 videofluoroscopic swallowing studies (VFSS) of patients with ACOs from electronic medical records was performed. Patients with other diseases that could explain the dysphagia were excluded. Dysphagia characteristics and severity and clinical and radiological characteristics of subjects with ACOs were evaluated. Dysphagia characteristics and clinical course were compared among three treatment groups: surgical treatment, swallowing rehabilitation, and conservative treatment.
RESULTS
Subjects were 22 men and 1 woman with a mean age of 78.69±8.01 years. The mean osteophyte thickness was 9.07±3.84 mm. It was significantly thicker in the surgical group than that in other groups (p=0.01). ACOs were most frequently found at C5 level. This level also had the thickest osteophytes. However, videofluoroscopic dysphagia scales (VDS) were not significantly different among the three treatment groups. The pharyngeal phase score of the VDS was significantly higher in the surgical group (p=0.041). Dysphagia severity was decreased significantly in the surgical group at 3 months after the initial VFSS (p=0.004).
CONCLUSION
The main swallowing characteristics in patients with ACOs were dysphagia features of the pharyngeal phase, including inappropriate airway protection, decreased laryngeal elevation, and reduced epiglottis inversion. When determining treatment options, it may be helpful to consider dysphagia severity at pharyngeal phase and osteophyte thickness.

Keyword

Deglutition disorders; Osteophyte; Hyperostosis; Fluoroscopy; Surgical procedures

MeSH Terms

Deglutition
Deglutition Disorders*
Electronic Health Records
Epiglottis
Female
Fluoroscopy
Humans
Hyperostosis
Male
Osteophyte*
Rehabilitation
Retrospective Studies
Weights and Measures

Figure

• 

  Fig. 1. Flow diagram showing subject selection procedures.

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