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Plate Thickness as a Cause of Dysphasia

The purpose of this study was to explore why dysphagia or difficulty swallowing occurs following anterior neck surgery. Difficulty swallowing is known to occur prior to surgery in some individuals that have large bone growths called osteophytes from the vertebral bodies in the cervical spine. Given this, plate thickness has been thought to be a possible cause of difficulty swallowing after surgery. None of the 64 patients in the study had difficulty swallowing before surgery. The surgeon involved used the same plate thickness for all subjects. Nine of 30 patients in the group who had less protrusion from the surgical plate than they did from osteophytes before surgery developed difficulty swallowing. Five of the nine had difficulty swallowing chronically. Thirteen out of 34 patients in the group who had greater protrusion of their plate after surgery than their osteophytes before surgery developed difficulty swallowing. Six of the thirteen patients had chronic difficulty swallowing.

The authors concluded that from their experience with 64 patients, plate thickness seemed improbable as a source of difficulty swallowing. The authors felt that it was more likely that plates at the upper cervical spine (C3) were the cause of dysphagia. This may be becuase they require more moving and holding of soft tissue around the throat with instruments called retractors. They also felt that when smaller incisions were made, there was more vigorous retraction of the esophagus (the tube that connects the mouth with the stomach). They felt this could have been a cause for the difficulty swallowing after surgery. Surgery lasting longer than 175 minutes seemed more likely to contribute to post-operative difficulty swallowing.

References: Kingsley Chin, MD; James Eiszner, MD; Samuel Adams, Jr. MD. Role of Plate Thickness as a Cause of Dysphagia After Anterior Cervical. In Spine. November 2007. Volume 32. Number 23. Pp. 2585-2590.

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