Dysphagia Resource CenterServing the Dysphagia professional since 1995.
Resources for swallowing and swallowing disorders.

[Date Prev][Date Next] [Chronological] [Thread] [Top]

[DYSPHAGIA] cervical laminectomy



I am surprised you have these people in the hospital long enough to see the
problems develop. It's common in this region to have patients d/c 24 hours
after surgery...have surgery & out the next day. And to scare you even more
I heard from a RN friend in Nevada where the cervical lamis are done in
same day surgery...surgery and go home.

I have seen numerous lami patients with swallowing difficulties.
Fortunately few have had long lasting problems. I had an interesting case
with one lami...doctor couldn't figure out why she couldn't swallow. 54 y/o
female, anterior approach, should have done fine. In my interview with her
she reported her general practitioner said she should cut back on
concentrated sugars and salt. Stated when she ate potato chips her feet
would swell up for a week. MBS revealed severe pharyngeal swelling which
caused pt. to aspirate (don't recall all details other than severe
swelling). I asked the unit case manager to give her GP a call. This MD
reported the woman had needed to be on insulin for past year and was
non-complaint, also had bad HTN. He wasn't surprised when we explained
multiple post-op complications. We got her diabetes and HTN managed and
within 2 weeks swelling went down and swallow was normal. 

Moral of this story....always spend time taking a detailed interview with
the patient. I caught something even the neurosurgeon had missed. It would
be interesting to know if there are medical similarities among those who
develop dysphagia (HTN, diabetes, advanced age, etc.).

Sara

At 08:41 AM 12/21/00 -0800, you wrote:
>I work in a small community hospital.   I have seen the same with the 
>anterior approach cervical surgery due to significant post op edema.  The 
>ortho doc's are pretty good about referring.  Some of the time they do well 
>within several days but others take longer but USUALLY resolves in a couple 
>weeks, like Marilyn said.  I have seen a case, however that there was 
>permanent damage to CN X and he had to have a PEG. 
>
>Francesca Swift
>Harrison Hospitall
>Bremerton, WA
>
>>>> "M. Shelton" <mshelton@u.washington.edu> 12/21 6:20 AM >>>
>I work at a major trauma hospital in Seattle and work very closely with
>the Speech Pathologist regarding this issue.  We have started screening
>especially pt's who have undergone anterior approach C-spine surgery and
>have even recommended placing NG feeding tubes during surgery in case
>dysphagia occurs afterwards (this avoids the trauma of needing to place
>one when the patient is alert but having trouble after the procedure -
>it's already there).
>
>What we are finding is patients can tolerate a "clear liquid/DAT" shortly
>after the procedure (day 1-2) but by day 3 dysphagia is so severe in many
>cases (and uncomfortable too) that it is impossible to even attempt
>po's.  This can last as long as a few days to weeks.  It doesn't happen to
>all patients. We guess it may be related to the side if the spine that is
>approached, swelling  etc., but would welcome more info. The pt's span the
>age groups.....have not related this to age at this time.
>
>Sincerely, Marilyn Shelton RDCD, Harborview Medical Center, Seattle WA 
>
>On Wed, 20 Dec 2000 Mlieux@aol.com wrote:
>
>> 
>> I wanted to inquire about a common occurrence @ the hospital in which I 
>> currently work.  It seems as though there are too many incidences where 
>> patients have severe dysphagia after having spinal surgery.  The major 
>> problem with the patients we see is the severe pooling in the valleculae 
>with 
>> minimal pharyngeal pressure.  Please comment on any similar circumstances.  
>> We don't necessarily see aspiration but the amount of bolus remaining after 
>> several swallows is too dangerous to recommend any PO intake.  The doctors 
>> insist it is just a result of "old age".
>> 
>> m.lieux
>> ---------------------------------------------------------------------
>> To UNSUBSCRIBE from this list, please send an e-mail message to
>> majordomo@medonline.com with the following text as a message:
>> unsubscribe dysphagia
>> ---------------------------------------------------------------------
>> 
>
>---------------------------------------------------------------------
>To UNSUBSCRIBE from this list, please send an e-mail message to
>majordomo@medonline.com with the following text as a message:
>unsubscribe dysphagia
>---------------------------------------------------------------------
>
>---------------------------------------------------------------------
>To UNSUBSCRIBE from this list, please send an e-mail message to
>majordomo@medonline.com with the following text as a message:
>unsubscribe dysphagia
>---------------------------------------------------------------------

---------------------------------------------------------------------
To UNSUBSCRIBE from this list, please send an e-mail message to
majordomo@medonline.com with the following text as a message:
unsubscribe dysphagia
---------------------------------------------------------------------



Please send sugestions and comments to ppalmer@dysphagia.com."This site blew me away, I nearly choked!"
© 1996-2006 Phyllis M. Palmer, Ph.D.