The Role of Cricopharyngeal Myotomy After Anterior Cervical Decompression and Fusion Operations

World Neurosurg. 2020 May:137:146-148. doi: 10.1016/j.wneu.2020.01.180. Epub 2020 Feb 7.

Abstract

Background: Anterior cervical spine surgeries have low morbidity, sufficient surgical corridor, and quick recovery times. Although largely considered a safe and effective procedure to address cervical myelopathy, radiculopathy, and deformity, dysphagia is a frequent yet poorly understood adverse event. One treatment is cricopharyngeal myotomy (CPM), which aids in swallowing for patients with refractory issues after anterior cervical decompression and fusion (ACDF).

Case description: Here we describe our experience with 6 patients requiring revision ACDF with preoperative dysphagia who were treated with concurrent revision and CPM. Our series demonstrated that CPM is an effective and safe procedure used in combination with an ACDF. In our series, we had 6 patients with dysphagia preoperatively who were all able to undergo ACDF without worsening of their dysphagia despite having risk factors predisposing them to this complication. In our series, 83% of patients either improved or experienced resolution of their symptoms with only 1 patient failing to improve.

Conclusions: Given its efficacy and safety, patients planned for ACDF with preoperative dysphagia should be evaluated by ENT for potential CPM.

Keywords: ACDF; Anterior cervical decompression and fusion; Cricopharyngeal myotomy; Dysphagia; Revision; Swallowing.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae / surgery*
  • Cricoid Cartilage / surgery
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery*
  • Diskectomy / methods
  • Humans
  • Myotomy* / adverse effects
  • Pharyngeal Muscles / surgery
  • Postoperative Complications / etiology
  • Radiculopathy / surgery*
  • Spinal Cord Diseases / surgery*
  • Spinal Fusion / methods