The Impact of Cervical Spinal Disease on Pharyngeal Swallowing Function
Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic...
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Published in | American journal of speech-language pathology Vol. 32; no. 2; pp. 565 - 575 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Speech-Language-Hearing Association
09.03.2023
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Subjects | |
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Abstract | Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs).
A retrospective case-control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration-Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal-Wallis one-way analysis of variance.
Most patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups.
Spinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time. |
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AbstractList | PURPOSESpinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs).METHODA retrospective case-control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration-Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal-Wallis one-way analysis of variance.RESULTSMost patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups.CONCLUSIONSSpinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time. Purpose: Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs). Method: A retrospective case–control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration–Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal–Wallis one-way analysis of variance. Results: Most patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups. Conclusions: Spinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time. Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs). A retrospective case-control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration-Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal-Wallis one-way analysis of variance. Most patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups. Spinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time. |
Author | Nguyen, Shaun A Walters, Rameen K Gudipudi, Rachana Davidson, Kate Matheus, Maria G O'Rourke, Ashli K Martin-Harris, Bonnie Cooke, Melissa Barengo, Jenna Garand, Kendrea L Smyre, Drasti |
AuthorAffiliation | e Department of Otolaryngology—Head and Neck Surgery and Radiation Oncology, Northwestern University, Evanston, IL b Department of Speech-Language Pathology, Medical University of South Carolina, Charleston a Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston c Department of Speech Pathology and Audiology, University of South Alabama, Mobile d Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL f Department of Radiology, Medical University of South Carolina, Charleston |
AuthorAffiliation_xml | – name: e Department of Otolaryngology—Head and Neck Surgery and Radiation Oncology, Northwestern University, Evanston, IL – name: a Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston – name: c Department of Speech Pathology and Audiology, University of South Alabama, Mobile – name: f Department of Radiology, Medical University of South Carolina, Charleston – name: b Department of Speech-Language Pathology, Medical University of South Carolina, Charleston – name: d Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL |
Author_xml | – sequence: 1 givenname: Rameen K orcidid: 0000-0002-7823-3002 surname: Walters fullname: Walters, Rameen K organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston – sequence: 2 givenname: Rachana surname: Gudipudi fullname: Gudipudi, Rachana organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston – sequence: 3 givenname: Kate surname: Davidson fullname: Davidson, Kate organization: Department of Speech-Language Pathology, Medical University of South Carolina, Charleston – sequence: 4 givenname: Melissa surname: Cooke fullname: Cooke, Melissa organization: Department of Speech-Language Pathology, Medical University of South Carolina, Charleston – sequence: 5 givenname: Jenna surname: Barengo fullname: Barengo, Jenna organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston – sequence: 6 givenname: Drasti surname: Smyre fullname: Smyre, Drasti organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston – sequence: 7 givenname: Kendrea L surname: Garand fullname: Garand, Kendrea L organization: Department of Speech Pathology and Audiology, University of South Alabama, Mobile – sequence: 8 givenname: Bonnie orcidid: 0000-0001-7840-3764 surname: Martin-Harris fullname: Martin-Harris, Bonnie organization: Department of Otolaryngology-Head and Neck Surgery and Radiation Oncology, Northwestern University, Evanston, IL – sequence: 9 givenname: Maria G surname: Matheus fullname: Matheus, Maria G organization: Department of Radiology, Medical University of South Carolina, Charleston – sequence: 10 givenname: Shaun A surname: Nguyen fullname: Nguyen, Shaun A organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston – sequence: 11 givenname: Ashli K surname: O'Rourke fullname: O'Rourke, Ashli K organization: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston |
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Snippet | Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function.... Purpose: Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing... PURPOSESpinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing... |
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SubjectTerms | Case-Control Studies Deglutition - physiology Deglutition Disorders - diagnosis Deglutition Disorders - etiology Humans Retrospective Studies Spinal Diseases - complications |
Title | The Impact of Cervical Spinal Disease on Pharyngeal Swallowing Function |
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