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경추 움직임에 제한을 보이는 강직성 척추염 환자의 전방접근경추수술 후 발생한 연하장애 - 증례 보고

Other Titles
 Dysphagia Following Anterior Approach Cervical Spinal Surgery in a Patient with Ankylosing Spondylitis 
Authors
 윤왕현  ;  박진영  ;  박준상  ;  김도영  ;  박중현 
Citation
 Journal of the Korean Dysphagia Society (대한연하장애학회지), Vol.8(2) : 117-120, 2018 
Journal Title
 Journal of the Korean Dysphagia Society (대한연하장애학회지) 
ISSN
 2233-5978 
Issue Date
2018
Keywords
Ankylosing spondylitis ; Dysphagia ; Cervical vertebrae
Abstract
The known causes of dysphagia following cervical spine surgery include pre-vertebral soft tissue swelling, decreased posterior pharyngeal movement, and impaired upper esophageal sphincter opening. Some studies have suggested that dysphagia is associated with movement of the cervical vertebrae during swallowing. In the present case, a 59-year-old man with a limited cervical range of motion due to ankylosing spondylitis slipped and fell, resulting in a C7 vertebral body fracture. He underwent anterior cervical discectomy as well as C5-T1 anterior fusion and C5-T2 level postero-lateral fusion. After surgery, he showed signs and symptoms of aspiration. A video-fluoroscopic swallowing study (VFSS) revealed incomplete laryngeal elevation, cricopharyngeal dysfunction, and vallecular remnant. Aspiration was observed in the semisolid-swallowing test. The patient’s dysphagia could be attributed to two main causes. First, the esophagus might have been compressed by thickened pre-vertebral soft tissue after surgery. Second, the cervical range of motion, which was already limited by ankylosing spondylitis, might have been limited further by the anterior fusion of the cervical spine. In conclusion, a preoperative evaluation, including VFSS, should be considered before cervical spinal surgery, particularly in patients with ankylosing spondylitis presenting with a limited cervical range of motion.
Files in This Item:
T201806077.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Park, Jung Hyun(박중현) ORCID logo https://orcid.org/0000-0003-3262-7476
Park, Jinyoung(박진영) ORCID logo https://orcid.org/0000-0003-4042-9779
Yun, Wang Hyeon(윤왕현)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170868
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