Ghaly RF, Aldrete JA

Language: English
References: 29
Page: 74-79
PDF size: 121.67 Kb.

ABSTRACT

Background: Dysphagia along with cervical pain may be due either to large osteophytes of the cervical vertebrae or to an anteriorly herniated cervical disk. Objectives: Identifying the clinical and radiological features of cervical osteophytosis and anterior disk herniation severe enough to cause dysphagia. Methods: Seventy nine patients with neck pain and dysphagia were studied, 49 women (62%) and 30 men (38%). Twenty two of them (28%) were diagnosed with skeletal hyperostosis, 21 (26%) had isolated osteophytosis and 36 (45%) had an anterior herniated cervical disk between C2 and C7. A medical history and physical exam were performed, plus an MRI, 3D or regular CAT scan and a cervical spine x-RAY series. Barium swallow was done in patients with painful swallowing (odynophagia). Nerve conduction studies plus evoked potentials were performed in patients with brachial radiculopathy. Results: Out of 79 patients, 62 (65.8%) had foreign body sensation in the pharynx and 27 (39%) had difficulty swallowing solid foods; 14 (51%) of the latter had pain on swallowing. Of these 52 patients, 49 (94%) had hypertension with moderate obesity. Out of the latter, 41 (78.8%) had moderate obesity (between 20 and 39% over the ideal body weight [BW]) and 11 (21%) had severe obesity (‹ 40% over the ideal BW). Twenty seven patients below their ideal BW had difficulty swallowing, out of which 12 (33.7%) had odynophagia. Those with radiculopathy usually had lateral foramen impingement of nerve roots. Conclusions: The association of neck pain and dysphagia needs a complete work-up to determine its origin and extent and to identify the predominant symptom, which may require surgical fusion or conservative interventional therapy.

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