Dysphagia due to cervical osteophytes: A controversial entity revisited

Parker, Michael D.

doi:10.1007/bf02407134

Cited by 16 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cause of local inflammation is thought to be the result of repetitive mechanical trauma caused by the constant dynamic movement of the pharyngolarnygoesophageal complex over the large hypertrophic hyperostoses [5,7,[19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Management of Dysphagia and Airway Obstruction in Patients with Prominent Ventral Cervical Osteophytes

et al. 2010

View full text Add to dashboard Cite

Large projecting ventral cervical osteophytes are associated with senile degenerative skeletal disease, post-traumatic osteophytogenesis, and diffuse idiopathic skeletal hyperostosis (DISH). The vast majority of patients with cervical osteophytes are asymptomatic. However, in a small subset this condition may lead to upper aerodigestive compromise manifesting as dysphagia and/or airway obstruction. Conservative medical therapy is usually sufficient, but patients with intractable disease may require surgical intervention, including tracheostomy, feeding tube placement, or osteophytectomy. A retrospective chart review was performed on all patients who presented to a tertiary referral center over a decade (1998-2008) with complaints of dysphagia and/or respiratory compromise and underwent osteophytectomy for treatment of recalcitrant symptoms. A total of nine patients met criteria. Six patients were diagnosed with DISH, two with trauma-associated osteophytogenesis, and one with senile degenerative vertebral disease. The mean age was 68 years and included seven males and two females. All patients had symptoms of dysphagia and two had simultaneous airway complaints. All patients underwent an anterolateral approach for osteophyte decompression, one of which required concurrent tracheostomy. Following surgery, 100% of patients had significant improvement in dysphagia and respiratory complaints. Eight of nine patients returned to an unrestricted diet and only one required postoperative abstinence from bulky foods; both patients with additional airway complaints were successfully decannulated after surgery. Degenerative conditions and DISH may lead to osteophyte-associated dysphagia and/or airway complaints. Surgical decompression through osteophytectomy is an effective alternative to tracheostomy and feeding tube in carefully selected patients and should be considered for surgically fit patients who fail conservative medical management.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Cervical osteophytosis is a common finding in the elderly and occurs in approximately a third of all individuals over 60 years of age [1,5]. The vast majority of these patients are asymptomatic but a small percentage present with dysphagia and, less commonly, upper respiratory compromise [6,7].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Dysphagia and Airway Obstruction in Patients with Prominent Ventral Cervical Osteophytes

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Initial treatment strategies for OAD should be conservative, including diet modifications, postural changes, muscle relaxants, anti-reflux medications, and steroids. If conservative treatment is not effective, surgical treatment should be indicated for improving the patient’s quality of life (QOL) [ 2 – 5 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of surgery for osteophyte-associated dysphagia using the functional outcome swallowing scale

et al. 2018

View full text Add to dashboard Cite

PurposeTo investigate the surgical outcome of patients with osteophyte-associated dysphagia (OAD) using the functional outcome swallowing scale (FOSS).MethodsA retrospective chart review of 10 surgical cases of OAD (9 male and 1 female patient; mean age of 65 years) from 1982 to 2017 was performed, and radiographic evaluations were conducted by video fluoroscopic swallow study (VFSS) and conventional radiography. All OAD cases were treated at a single institution, and osteophytes were surgically resected by the anterior approach under gentle retraction of the affected esophagus. FOSS (0 for normal, 5 for worst) was used for clinical evaluations, and surgical complications were recorded.ResultsVFSS evaluation of OAD showed that the affected osteophyte was located at C4/5 in four patients, followed by C3/4 in three patients. The mean FOSS showed significant improvement from 2.5 preoperatively to 0.3 postoperatively, and no major surgical complications were recorded. Comorbidities were diabetes mellitus in four patients, ossification of the posterior longitudinal ligament in three patients, and lumbar spinal stenosis (LSS) in three patients.ConclusionSurgical treatment of OAD was promising, and all patients showed clinical recovery. Evaluation of dysphagia using FOSS was easy and reliable for OAD management, and FOSS 2 might be a good indication for surgical intervention.

show abstract

“…Anterior vertebral osteophytes and syndesmophytes are common radiological findings seen in the elderly adult population; yet they are rarely symptomatic. [1][2][3] These may be caused by spinal degeneration, previous trauma, prior surgery, or pathological conditions such as diffuse idiopathic skeletal hyperostosis (DISH). [4][5][6] When these bony growths become large enough, they can lead to dysphagia, dysphonia, dyspnea, and obstructive sleep apnea.…”

Section: Introductionmentioning

confidence: 99%

Anterior Cervical Osteophyte Resection for Treatment of Dysphagia

Kolz

Alvi

Bhatti

et al. 2020

Global Spine Journal

View full text Add to dashboard Cite

Study Design: This was a retrospective cohort study. Objectives: When anterior cervical osteophytes become large enough, they may cause dysphagia. There is a paucity of work examining outcomes and complications of anterior cervical osteophyte resection for dysphagia. Methods: Retrospective review identified 19 patients who underwent anterior cervical osteophyte resection for a diagnosis of dysphagia. The mean age was 71 years and follow-up, 4.7 years. The most common level operated on was C3-C4 (13, 69%). Results: Following anterior cervical osteophyte resection, 79% of patients had improvement in dysphagia. Five patients underwent cervical fusion; there were no episodes of delayed or iatrogenic instability requiring fusion. Fusion patients were younger (64 vs 71 years, P = .05) and had longer operative times (315 vs 121 minutes, P = .01). Age of 75 years or less trended toward improvement in dysphagia ( P = .09; OR = 18.8; 95% CI 0.7-478.0), whereas severe dysphagia trended toward increased complications ( P = .07; OR = 11.3; 95% CI = 0.8-158.5). Body mass index, use of an exposure surgeon, diffuse idiopathic skeletal hyperostosis diagnosis, surgery at 3 or more levels, prior neck surgery, and fusion were not predictive of improvement or complication. Conclusions: Anterior cervical osteophyte resection improves swallowing function in the majority of patients with symptomatic osteophytes. Spinal fusion can be added to address stenosis and other underlying cervical disease and help prevent osteophyte recurrence, whereas intraoperative navigation can be used to ensure complete osteophyte resection without breaching the cortex or entering the disc space. Because of the relatively high complication rate, patients should undergo thorough multidisciplinary workup with swallow evaluation to confirm that anterior cervical osteophytes are the primary cause of dysphagia prior to surgery.

show abstract

Dysphagia due to cervical osteophytes: A controversial entity revisited

Cited by 16 publications

References 21 publications

Surgical Management of Dysphagia and Airway Obstruction in Patients with Prominent Ventral Cervical Osteophytes

Surgical Management of Dysphagia and Airway Obstruction in Patients with Prominent Ventral Cervical Osteophytes

Clinical evaluation of surgery for osteophyte-associated dysphagia using the functional outcome swallowing scale

Anterior Cervical Osteophyte Resection for Treatment of Dysphagia

Contact Info

Product

Resources

About