Tracheal traction exercise reduces the occurrence of postoperative dysphagia after anterior cervical spine surgery

Spine (Phila Pa 1976). 2012 Jul 1;37(15):1292-6. doi: 10.1097/BRS.0b013e3182477f26.

Abstract

Study design: We designed a novel anterior cervical spine surgery preoperative treatment comprising mechanical trachea/esophagus traction and compared the postoperative outcome regarding dysphagia with nontreated patients.

Objective: We investigated whether the newly developed preoperative tracheal/esophageal traction exercise (TTE) treatment has an effect on postoperative dysphagia after anterior cervical spine surgery.

Summary of background data: Dysphagia is a postoperative complication that occurs after anterior cervical spine surgery, and known treatments are perioperative application of methylprednisolone, monitoring of endotracheal tube cuff pressure, and the use of low-profile plates. METHODS.: We compared the neck disability index, visual analogue scale scores for arm and neck pain, and Bazaz dysphagia scores, a dysphagia index, of 2 randomized groups, 1 week, 3 weeks, 6 weeks, 3 months, and 6 months after cervical spine surgery. One group received TTE treatment for 3 consecutive days before surgery, whereas the control group did not. RESULTS.: In the first week after operation, the Bazaz dysphagia scores for patients with second- to fourth-level fusions in the TTE group were significantly better than that in the control group (P = 0.000 for second- and third-level fusions and P = 0.013 for fourth-level fusion). Also at 3 weeks after surgery, the second- to fourth-level fusion patients in the TTE group had better Bazaz scores than those in the control group (P = 0.000 for second- and third-level fusions and P = 0.004 for fourth-level fusion). There was no significant difference of neck disability index and visual analogue scale scores between the 2 groups.

Conclusion: Dysphagia could be reduced in patients with multiple-level fusion after anterior cervical spine surgery by preoperative TTE treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bone Transplantation / methods
  • Cervical Vertebrae / surgery*
  • Deglutition Disorders / prevention & control*
  • Esophagus / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods
  • Spinal Fusion / methods
  • Trachea / physiopathology*
  • Traction / methods
  • Transplantation, Homologous
  • Treatment Outcome