Objective To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.Methods Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).Results The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.Conclusion There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

Vertebral osteomyelitis (VO) is a rare, slowly progressing disease that often causes neuromuscular complications. Epidural block is a non-surgical treatment used in patients with radicular pain to deliver drugs to the epidural space; it is generally known to be a safe method, but it can occasionally cause infection. Herein, we present a rare case of VO with severe neuromuscular complications that developed in a patient who underwent lumbar transforaminal epidural block for back pain. Imaging studies showed VO, multiple pyogenic abscesses, and compressive cervical myelopathy. Electrodiagnostic studies showed clear evidence of cervical myelopathy and polyradiculopathy. With early treatment using a multidisciplinary approach, including medical treatment, surgery, and comprehensive rehabilitation, recovery of motor weakness and functional improvement were achieved after 2 months of treatment. Electrodiagnostic studies are advantageous for localizing and determining the degree of neuromuscular damage following VO. A multidisciplinary approach to the diagnosis and treatment of VO could improve patients’ prognosis, functional ability, and quality of life.