椎前软组织肿胀和颈椎前路融合术后吞咽困难的相关性研究

Analysis the correlation between prevertebral soft-tissue swelling and dysphagia after anterior cervical spine surgery

目的探讨颈椎前路融合术后椎前软组织肿胀和吞咽困难是否存在相关性。方法随访研究自2009-01—2011-01接受颈椎前路融合术的患者73例,按照Bazaz-Yoo吞咽困难评分方法分为正常组(无/轻症状组,n=38)和吞咽困难组(中/重症状组,n=35),参照Penning法测量颈椎侧位X线片上术前、术后软组织宽度,分析2组椎前软组织宽度变化值(即椎前软组织肿胀程度)。结果 2组间术前椎前软组织宽度比较,差异无统计学意义(P>0.05),2组间术前-术后椎前软组织宽度变化值有显著差异,吞咽困难组明显高于正常组,差异有统计学意义(P<0.05)。结论颈椎前路融合术后椎前软组织肿胀和吞咽困难的发生具有正相关性,推测椎前软组织肿胀可能是吞咽困难发生的机制之一。椎前软组织肿胀(程度)作为预测颈椎前路融合术后吞咽困难发生率的有效指标,具有一定的临床指导意义。

Objective To investigate the correlation between prevertebral soft-tissue swelling and postoperative dysphagia after anterior cervical spine surgery. Methods Seventy-three patients who underwent elective anterior cervical spine surgery from January 2009 to January 2011 and completed a dysphagia questionnaire were included in the study. The presence and severity of chronic dysphagia was assessed using the Bazaz-Yoo Dysphagia Score. All the patients were divided into two groups （normal group, n =38; dysphagia group, n =35） according to the Bazaz-Yoo Dysphagia Score. Soft-tissue width was measured on plain lateral cervical radiographs according to the Penning＂ method preoperatively and postoperatively to assess the degree of soft-tissue swelling. The two groups were compared with respect to the degree of soft-tissue swelling. Results The preoperative soft-tissue width was similar between the two groups （P 〉0.05）. But postoperative soft-tissue width was significantly more increased in dysphagia group than normal group （P 〈0.05）. Conclusion There might be a positive correlation between prevertebral soft-tissue swelling and postoperative dysphagia after anterior cervical spine surgery. Prevertebral soft-tissue swelling might be one of the mechanisms of postoperative dysphagia. Prevertebral soft-tissue swelling may be used to assess the incidence of postoperative dysphagia, possessing instructive clinical significance.