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Rehabilitation Practice and Science

Translated Title

頸椎前位式椎間盤切除術後嚴重吞嚥障礙：病例報告

Abstract

The anterior approach is popularized among neurosurgeons for operative exposure of the cervical spine. However, neurological complications of this approach are not uncommon, and little research had been performed regarding the etiology and optimal treatment. The common complications include dysphonia and mild dysphagia. The etiologies of dysphagia following the anterior approach are: (1) hematoma formation, (2) intraoperative tissue damage with subsequent edema, (3) infection, and (4) denervation. Videofluoroscopic examination of swallowing is the most common measurement of cricoph-aryngeal dysfunction; manometry is also used, but to a lesser degree. For cricopharyngeal achalasia, there are five approaches to manage, including: (1) Mendelsohn’s maneuver, (2) the external technique to myotomy, (3) the endoscopic approach, (4) balloon dilation of the cricopharyngeus, (5) botulinum toxin injection of the cricopharyngeus percutaneously or endoscopically.This case was a 63-year-old male patient who suffered from severe dysphagia following anterior discectomy and instrument fixation due to C3-4 subluxation. Wasting of the paralysed right half of the tongue with deviation to right side was noted. Cricopharyngeal achalasia and aspiration after swallowing were confirmed with the videofluoroscopic examination. After 3 months, severe dysphagia was ameliora-ted by the Mendelsohn’s maneuver. We reported this case to discuss the etiology, diagnostic methods, and treatments about the dysphagia following the anterior approach to cervical spine.

Language

Traditional Chinese

First Page

57

Last Page

62

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