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

Abstract

Dysphagia (swallowing impairment) is a frequent complication of cervical spinal cord injury (cSCI). Recently published national guidance in the UK on rehabilitation after traumatic injury confirmed that people with cSCI are at risk for dysphagia and require early evaluation while remaining nil by mouth [National Institute for Health and Care Excellence. Rehabilitation after traumatic injury (NG211), 2022, https://www.nice.org.uk/guidance/ng21 ]. While the pathogenesis and pathophysiology of dysphagia in cSCI remains unclear, numerous risk factors have been identified in the literature. This review aims to summarize the literature on the risk factors, presentation, assessment, and management of dysphagia in patients with cSCI. A bespoke approach to dysphagia management, that accounts for the multiple system impairment in cSCI, is presented; the overarching aim of which is to support effective management of dysphagia in patients with cSCI to prevent adverse clinical consequences.

Keywords: Cervical spinal cord injury; Deglutition; Dysphagia; Risk factors; Speech and language therapy.

Fig. 1

a Radiographic image of a C4-5 plate with posterior pharyngeal wall thickening (3 weeks post surgery). b Radiographic image of C6/7 anterior fixation with plate with altered C-spine alignment (5 months post surgery) (with permissions)