J Korean Dysphagia Soc.  2024 Jul;14(2):109-115. 10.34160/jkds.24.001.

Two Cases of Dysphagia as a Secondary Postoperative Complication after Anterior Cervical Spine Fusion

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Abstract

Dysphagia frequently presents in patients with a cervical spinal cord injury following anterior cervical spine fusion (ACSF). However, it is essential to identify the cause of dysphagia because it can occur due to a variety of reasons, such as structural lesions, psychiatric problems, as well as neurologic impairment. We report two cases of dysphagia as secondary postoperative complications after ACSF. The first case was a 60-year-old male who experienced pain while swallowing, having undergone C3/4 ACSF due to traumatic retrolisthesis at C3/4. A videofluoroscopic swallowing study (VFSS) demonstrated a delayed swallowing reflex and liquid penetration. A cervical spine magnetic resonance imaging (MRI) showed a deep neck infection at the C4-7 level. Following intravenous antibiotic administration, the patient’s pain significantly improved. The second case was that of a 74-year-old female who underwent C3/4 ACSF due to an accidental fall. A VFSS demonstrated post-swallowing liquid aspiration. However, she complained of a foreign sensation in the throat and aspiration. A cervical spine computed tomography (CT) showed a suspected hardware loosening, which interfered with the passage of food. In patients with a cervical spinal cord injury, mechanical problems related to the surgery can be a cause of swallowing difficulty. Prompt identification and treatment of these complications are essential for patient recovery.

Keyword

Dysphagia; Spinal cord injury; Spinal fusion; Hypopharyngitis
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