Dysphagia Associated with Cervical Spine and Postural Disorders

Abstract

Difficulties with swallowing may be both persistent and life threatening for the majority of those who experience it irrespective of age, gender, and race. The purpose of this review is to define oropharyngeal dysphagia and describe its relationship to cervical spine disorders and postural disturbances due to either congenital or acquired disorders. The etiology and diagnosis of dysphagia are analyzed, focusing on cervical spine pathology associated with dysphagia as severe cervical spine disorders and postural disturbances largely have been held accountable for deglutition disorders. Scoliosis, kyphosis–lordosis, and osteophytes are the primary focus of this review in an attempt to elucidate the link between cervical spine disorders and dysphagia. It is important for physicians to be knowledgeable about what triggers oropharyngeal dysphagia in cases of cervical spine and postural disorders. Moreover, the optimum treatment for dysphagia, including the use of therapeutic maneuvers during deglutition, neck exercises, and surgical treatment, is discussed.

Effects of Cervical Kyphosis on Recovery From Dysphagia After Stroke

“…It is well-known that the DCFs are weakened in cervical kyphosis [1718]. Although the DCFs do not play a major role in swallowing function, a review article on dysphagia related to cervical and postural disorders suggested that weakening of the DCFs (longus colli and longus capitis) could cause problems in the swallowing process [1]. In particular, the longus colli muscle stabilizes the cervical spine during talking, coughing, and swallowing, and weakening of this muscle reduces stability during swallowing [19].…”

“…The normal angle of curvature varies according to sex, age, and measuring methods of reporters. Various methods are currently used to measure the curvature of the cervical spine, including McGregor's line and the Harrison posterior tangent method; however, measurement of Cobb's angle is the most commonly used method, which defines angles between 20° and 60° as normal cervical curvature [1]. …”

“…Cervical kyphosis can occur as a result of iatrogenic processes or systemic arthritides such as degenerative disc disease, external trauma, neoplastic disease, infection, ankylosing spondylitis, or rheumatoid arthritis; it can also occur without underlying diseases [3]. Cervical kyphosis can cause pain in the cervical spine, neuropathic pain, and neurologic problems such as muscle weakness, sensory impairment, or gait impairment due to pressure on the spinal cord or spinal nerve roots; in severe cases, it may cause tetraplegia or respiratory difficulties [134]. Moreover, several studies have reported an association with dysphagia [23].…”

“…When cervical kyphosis is accompanied by dysphagia, it may aggravate disorders of the pharynx [1]. These disorders also show a high incidence in stroke patients, separate from that of cervical kyphosis.…”

Functional Modules of Pharyngeal Swallowing Mechanics

“…Both configurations demonstrate the importance of head and neck posture as a functional module, which is underscored by dysphagia associated with cervical neck disorders. 42…”