Objective
To investigate the correlation of the severity of dysphagia and radiologic parameters in cervical spine disorders.
Method
A retrospective study was conducted by medical records review on 28 cervical spine disorders patients with symptoms of dysphagia. Enrolled patients were diagnosed with cervical spine disorders by a neurologist, neurosurgeon, or orthopedist and admitted to our institution from 14 November 1998 to 3 June 2020. All subjects underwent videofluoroscopic swallowing study (VFSS). Cervical X-rays were done before and after the onset of swallowing difficulty. We included patients who either had surgery or conservative treatment. Exclusion criteria were the presence of combined brain disease, history of dysphagia before cervical spine disorders.
We evaluated the dysphagia outcome and severity scale (DOSS) to rate swallowing function as a seven-point scale. For radiologic parameters, differences in oropharyngeal diameter (OPD), C0-C2 angle and C2-C7 angle (dOPD, dC0-C2 angle, dC2-C7 angle) were measured on cervical X-rays before and after the onset of swallowing problem. Correlation between the dysphagia severity (DOSS) and radiologic parameters was calculated by Spearman correlation coefficient. We used Mann-Whitney U test to compare characteristics between severe dysphagia group (DOSS<4) and mild dysphagia group (DOSS≥4). The Data analysis was performed using IBM SPSS Statistics v21.0 for Windows and P< 0.05 was considered statistically significant.
Results
Table 1 showed demographic characteristics of the enrolled patients (N=28). In Table 2, there were significant negative correlations between DOSS and dOPD (r. -0.747, P< 0.01), dC0-C2 angle (r. -0.785, P< 0.01), dC2-C7 angle (r. -0.777, P< 0.01). Age, sex, surgical methods variables were distributed evenly between severe dysphagia group and mild dysphagia group, but there was a significant difference in Tracheostomy, dOPD, dC0-C2 angle, dC2-C7 angle variables between two groups (Table 3).
Conclusion
This study shows that the dOPD, dC0-C2 angle, dC2-C7 angle in cervical X-rays have strong correlations with the severity of dysphagia in patients with cervical spine disorders. This finding might help physicians predict dysphagia early and prevent complication by screening. |
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Table 1. Demographic and Clinical Characteristics of Patients
Table 2. Correlation between the Severity of Dysphagia and Clinical Characteristics and Radiologic Parameters (Spearman’s Coefficient, r)
Table 3. Mann-whitney U test for Comparing Characteristics between Severe Dysphagia Group and Mild Dysphagia Group
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