背景:颈前路椎间盘切除融合术(ACDF)后吞咽困难是一种常见的术后并发症。然而,关于术后吞咽困难康复策略的信息有限.在这里,我们报告了一种治疗ACDF后吞咽困难的代偿策略.
方法:一名65岁的亚洲男性,表现为左臂疼痛和虚弱超过1个月。颈椎的磁共振成像显示椎间盘退行性病变和C3至C7水平的椎管狭窄。患者接受C3至C5水平的ACDF和通过右侧入路在C5至C7水平的人工椎间盘置换。手术后,患者抱怨吞咽困难。视频透视吞咽研究(VFSS)在咽部阶段检测到吞咽功能障碍,在前后视图中显示不对称的咽部残留物。
方法:患者在ACDF后被诊断为吞咽困难。
方法:基于VFSS的发现,患者接受了吞咽康复治疗和代偿技术,例如头部旋转到弱右侧和头部倾斜到坚固的左侧。
结果:经过2个月的补偿技术康复,食物平稳地向健壮的一面移动,吞咽困难的主观症状得到改善。
结论:因此,必须评估ACDF手术后的吞咽功能;如果检测到单侧吞咽困难,补偿技术可能被证明是有益的。这个案例研究表明,根据VFSS的客观发现,可以建立有效的吞咽补偿策略,并将其应用于术后吞咽困难的患者。
BACKGROUND: Dysphagia after anterior cervical discectomy and fusion (ACDF) is a common postoperative complication. However, information regarding rehabilitation strategies for postoperative dysphagia is limited. Herein, we report a compensatory strategy for treating dysphagia after ACDF.
METHODS: A 65-year-old Asian male presented with left arm pain and weakness for more than 1 month. Magnetic resonance imaging of the cervical spine revealed degenerative disc lesions and spinal stenosis at the C3 to C7 levels. The patient underwent ACDF at the C3 to C5 levels and artificial disc replacement at the C5 to C7 levels by right side approach. After surgery, the patient complained of difficulty swallowing. A video fluoroscopic swallowing study (VFSS) detected swallowing dysfunction in the pharyngeal phase, revealing an asymmetric pharyngeal residue in the anterior-posterior view.
METHODS: The patient was diagnosed with dysphagia after ACDF.
METHODS: Based on the VFSS findings, the patient underwent swallowing rehabilitation therapy and compensatory techniques, such as head rotation to the weak right side and head tilting to the robust left side.
RESULTS: After 2 months of rehabilitation with compensatory techniques, food moved smoothly towards the robust side, and the subjective symptoms of dysphagia improved.
CONCLUSIONS: Consequently, swallowing function post-ACDF surgery must be assessed; if unilateral dysphagia is detected, compensatory techniques may prove beneficial. This
case study showed that, based on the objective findings of the VFSS, an effective swallowing compensation strategy can be established and applied to patients with postoperative dysphagia.