The Role of Cricopharyngeal Myotomy After Anterior Cervical Decompression and Fusion Operations.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
05 2020
Historique:
received: 19 11 2019
revised: 21 01 2020
accepted: 22 01 2020
pubmed: 10 2 2020
medline: 15 7 2020
entrez: 10 2 2020
Statut: ppublish

Résumé

Anterior cervical spine surgeries have low morbidity, sufficient surgical corridor, and quick recovery times. Although largely considered a safe and effective procedure to address cervical myelopathy, radiculopathy, and deformity, dysphagia is a frequent yet poorly understood adverse event. One treatment is cricopharyngeal myotomy (CPM), which aids in swallowing for patients with refractory issues after anterior cervical decompression and fusion (ACDF). Here we describe our experience with 6 patients requiring revision ACDF with preoperative dysphagia who were treated with concurrent revision and CPM. Our series demonstrated that CPM is an effective and safe procedure used in combination with an ACDF. In our series, we had 6 patients with dysphagia preoperatively who were all able to undergo ACDF without worsening of their dysphagia despite having risk factors predisposing them to this complication. In our series, 83% of patients either improved or experienced resolution of their symptoms with only 1 patient failing to improve. Given its efficacy and safety, patients planned for ACDF with preoperative dysphagia should be evaluated by ENT for potential CPM.

Sections du résumé

BACKGROUND
Anterior cervical spine surgeries have low morbidity, sufficient surgical corridor, and quick recovery times. Although largely considered a safe and effective procedure to address cervical myelopathy, radiculopathy, and deformity, dysphagia is a frequent yet poorly understood adverse event. One treatment is cricopharyngeal myotomy (CPM), which aids in swallowing for patients with refractory issues after anterior cervical decompression and fusion (ACDF).
CASE DESCRIPTION
Here we describe our experience with 6 patients requiring revision ACDF with preoperative dysphagia who were treated with concurrent revision and CPM. Our series demonstrated that CPM is an effective and safe procedure used in combination with an ACDF. In our series, we had 6 patients with dysphagia preoperatively who were all able to undergo ACDF without worsening of their dysphagia despite having risk factors predisposing them to this complication. In our series, 83% of patients either improved or experienced resolution of their symptoms with only 1 patient failing to improve.
CONCLUSIONS
Given its efficacy and safety, patients planned for ACDF with preoperative dysphagia should be evaluated by ENT for potential CPM.

Identifiants

pubmed: 32036068
pii: S1878-8750(20)30198-4
doi: 10.1016/j.wneu.2020.01.180
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

146-148

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Kevin Hines (K)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. Electronic address: kevin.hines@jefferson.edu.

Geoffrey Stricsek (G)

Department of Neurosurgery, Emory University Hospital, Atlanta, Georgia, USA.

Aria Mahtabfar (A)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Srinivas Prasad (S)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Jack Jallo (J)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Ashwini Sharan (A)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Joshua Heller (J)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Mauritis Boon (M)

Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Colin Huntley (C)

Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Joseph Spiegel (J)

Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

James Harrop (J)

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH