Oropharyngeal Dysphagia in Acute Cervical Spinal Cord Injury: A Literature Review.
Jackie McRae, Sarah Morgan, Emma Wallace and 1 others
PMID 36374337WHAT IT FOUND
Dysphagia is common after cervical spinal cord injury, often silent and linked to tracheostomy, surgery, or respiratory impairment.
Screening must account for reduced sensation. Specialist speech-language pathology input is recommended for assessment and tailored rehabilitation.
Key findings
01Dysphagia prevalence in cervical spinal cord injury ranges from 16% to 60%, likely due to differences in definition, assessment tools, and patient factors.
02Patients with tracheostomy are at high risk of silent aspiration due to reduced laryngeal sensation and impaired cough, making bedside screening alone unreliable.
03Tracheostomy is a significant independent risk factor for dysphagia, with one study reporting a 3.67 relative risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review notes significant heterogeneity in the included studies, with varying definitions of dysphagia, assessment methods, and patient populations (traumatic vs. non-traumatic, acute vs. chronic). Most evidence comes from observational studies or case series; there is a lack of high-quality randomized controlled trials evaluating specific dysphagia interventions in this population. The prevalence rates cited vary widely (8% to 80% in some individual studies summarized), reflecting the difficulty in standardizing diagnosis.
Declared interests
No specific funding sources or conflicts of interest are declared in the provided text.
The easy way to misread this
Do not assume that a normal bedside swallow screen rules out dysphagia in patients with cervical spinal cord injuries, especially those with tracheostomies, as silent aspiration is common due to reduced sensation.