Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review

McRae, Jackie; Morgan, Sarah; Wallace, Emma; Miles, Anna

doi:10.1007/s00455-022-10535-0

Cited by 14 publications

(14 citation statements)

References 129 publications

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“…Deficits include chronic pain, loss of bladder control, respiratory system strain, and loss of motor function causing immobility below the injury level. Recent studies have estimated that the overall global prevalence of SCI is 20.6 million cases and 250,000 to 500,000 patients each year suffer from SCI [ 1 , 2 ]. After SCI, a tissue scar forms surrounding the injury epicenter composed of glial and supporting cell types.…”

Section: Introductionmentioning

confidence: 99%

Current Advancements in Spinal Cord Injury Research—Glial Scar Formation and Neural Regeneration

Clifford

Finkel

Rodriguez

et al. 2023

Cells

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Spinal cord injury (SCI) is a complex tissue injury resulting in permanent and degenerating damage to the central nervous system (CNS). Detrimental cellular processes occur after SCI, including axonal degeneration, neuronal loss, neuroinflammation, reactive gliosis, and scar formation. The glial scar border forms to segregate the neural lesion and isolate spreading inflammation, reactive oxygen species, and excitotoxicity at the injury epicenter to preserve surrounding healthy tissue. The scar border is a physicochemical barrier composed of elongated astrocytes, fibroblasts, and microglia secreting chondroitin sulfate proteoglycans, collogen, and the dense extra-cellular matrix. While this physiological response preserves viable neural tissue, it is also detrimental to regeneration. To overcome negative outcomes associated with scar formation, therapeutic strategies have been developed: the prevention of scar formation, the resolution of the developed scar, cell transplantation into the lesion, and endogenous cell reprogramming. This review focuses on cellular/molecular aspects of glial scar formation, and discusses advantages and disadvantages of strategies to promote regeneration after SCI.

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Section: Introductionmentioning

confidence: 99%

Current Advancements in Spinal Cord Injury Research—Glial Scar Formation and Neural Regeneration

Clifford

Finkel

Rodriguez

et al. 2023

Cells

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“…Dysphagia is a common secondary complication that often accompanies cervical spinal cord injury (CSCI). The incidence of dysphagia in individuals with CSCI ranges from 20%-40% [1][2][3][4]. Dysphagia requires attention because it can cause fatal respiratory diseases such as aspiration pneumonia, one of the leading cause of death among individuals with CSCI [5].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported risk factors for dysphagia in CSCI. Dysphagia may be (1) directly related to the neural injury itself, (2) the result of subsequent interventions (i.e., surgeries and spinal hardware), or (3) related to postsurgical complications of injury management (i.e., tracheostomy and postsurgical edema) [4]. Tracheostomy and spinal surgery via an anterior approach are representative predictors of dysphagia in CSCI [1,2,8].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary function and sarcopenia as predictors of dysphagia in cervical spinal cord injury

Lee

Shin

2023

Preprint

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Study design: Retrospective cohort study. Objective: To determine the risk factors associated with dysphagia in individuals with cervical spinal cord injury (CSCI) and analyze the differences between individuals with improved penetration-aspiration (PA) and persistent PA on follow-up. Setting: Tertiary inpatient rehabilitation facilities. Methods: Medical records of individuals with CSCI admitted between December 2009 and February 2023 who underwent a videofluoroscopic swallowing study (VFSS) were retrospectively reviewed. Multivariate logistic regression analysis was performed to assess risk factors for dysphagia. Differences between individuals with improved PA and persistent PA were analyzed using an independent t-test. Results: In total, 149 participants were enrolled. Age (odds ratio (OR) 1.077, 95% confidence interval (CI), 1.043 to 1.118), percentage of forced vital capacity to predicted normal (FVC (% predicted)) (OR 0.897, 95% CI, 0.850 to 0.941), and skeletal muscle mass ratio (SMMR) (OR 0.888, 95% CI, 0.791 to 0.991) were significant factors associated with the risk of PA. According to the receiver operating characteristic curve analysis, the cut-off values for age, FVC (% predicted), and SMMR were 55.50, 46.11, and 41.01, respectively. A secondary analysis of the follow-up VFSS was performed in 38 participants. The follow-up FVC(%predicted) and degree of weight loss differed significantly between the improved PA and persistent PA groups. Conclusions: Older age, low FVC (% predicted), and low SMMR can be predictors of dysphagia in patients with CSCI. On follow-up VFSS, individuals with improved PA demonstrated greater improvement in FVC (% predicted).

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“…Cervical spinal cord injury can result in tetraplegia and dysphagia [ 1 , 2 ]. The incidence of dysphagia secondary to cervical spinal cord injury can vary from 7% to 80% [ 1 , 3 , 4 ]. Dysphagia after cervical spinal cord injury can result in aspiration pneumonia, increasing morbidity and mortality [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of dysphagia secondary to cervical spinal cord injury can vary from 7% to 80% [ 1 , 3 , 4 ]. Dysphagia after cervical spinal cord injury can result in aspiration pneumonia, increasing morbidity and mortality [ 3 , 4 ]. To avoid unfavorable sequelae and to maintain nutrition in patients with tetraplegia and dysphagia related to cervical spinal cord injury, early detection and management of dysphagia seem essential [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Successful Continuation of Oral Intake in a Dysphagic and Tetraplegic Patient With Alternate Right and Left Complete Lateral Decubitus Positions in Rehabilitation

Maki¹,

Takagawa²,

Goda³

et al. 2023

Cureus

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Cervical spinal cord injury can result in dysphagia and tetraplegia. Dysphagia therapy can be required to avoid aspiration pneumonia during oral intake for persons with cervical spinal cord injury. Complete lateral decubitus position may be a specific position for safe swallowing. However, the literature on dysphagia therapy in complete lateral decubitus position for persons with tetraplegia and dysphagia is limited. We present the case of a 76-year-old man with dysphagia and tetraplegia secondary to cervical cord injury. As the patient wished for oral intake, swallowing training in an elevated position of the head at 60° was already initiated. Two days after admission, aspiration pneumonia occurred. As the spasticity increased continuously, the patient could not comfortably undertake swallowing training in an elevated head position of 60°. The flexible endoscopic evaluation of swallowing (FEES) was performed for the patient. The patient did not swallow water or jelly safely in an elevated head position. However, the patient swallowed jelly safely in the right complete lateral decubitus position. Two months after the initiation of oral intake in the right complete lateral decubitus position, the second FEES revealed that the patient swallowed jelly and food in the form of paste safely in the left complete lateral decubitus position. To relieve the pain of the right shoulder induced by continuous right complete lateral decubitus position, the patient retained oral intake in the left or right complete lateral decubitus position alternately for six months without recurrent aspiration pneumonia. Right and left complete lateral decubitus positions when alternately performed in swallowing training can be useful and safe for a patient with dysphagia and tetraplegia secondary to cervical spinal cord injury.

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Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review

Cited by 14 publications

References 129 publications

Current Advancements in Spinal Cord Injury Research—Glial Scar Formation and Neural Regeneration

Current Advancements in Spinal Cord Injury Research—Glial Scar Formation and Neural Regeneration

Pulmonary function and sarcopenia as predictors of dysphagia in cervical spinal cord injury

Successful Continuation of Oral Intake in a Dysphagic and Tetraplegic Patient With Alternate Right and Left Complete Lateral Decubitus Positions in Rehabilitation

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