Location
Philadelphia, PA
Start Date
17-4-2026 1:30 PM
End Date
17-4-2026 2:30 PM
Description
Introduction: Dysphagia is a commonly reported complication following anterior cervical disc fusion (ACDF). Some of the risk factors that increase dysphagia incidence include elevated BMI, smoking, female gender, and diabetes mellitus type 2. Treatment with methylprednisone administration and manipulation of endotracheal cuff pressures has been correlated with milder dysphagia in the intraoperative and early post-operative period; however, long-term differences between the control and treatment groups have not been statistically significant. Tracheal traction exercises are of emerging interest for treating ACDF patients with dysphagia. The purpose of this systematic review is to explore the outcome of the use of pre-operative tracheal traction exercises to reduce the incidence of or diminish the length of dysphagia among ACDF patients.
Methods: Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, observational studies were identified and collected for a systematic review. Inclusion criteria required discussion of anterior cervical discectomy and fusion, tracheal traction exercises, and dysphagia. Dysphagia was graded using various universal scoring systems, including the Bezaz Dysphagia Scale, Modified Dysphagia Scoring System, and Visual Analog Scale. Methodological index for non-randomized studies (MINORS) criteria were calculated to evaluate potential bias and the validity of the studies being analyzed. All studies included in this scoping review were evaluated using the comparative scoring system.
Results: In the preliminary search of Cochrane, scopus, embase, and PubMed, 1501 articles were identified. Of the analyzed articles, 1492 were excluded due to irrelevance to the scope of our study; of the 9 remaining, only 5 were available and reviewed tracheal traction. The MINORS criteria scoring placed all of the studies in the moderate category with scores between 15-22. Of the included articles, four of five showed lower scores, indicating less severe or no dysphagia with TTE compared to no treatment. The timing of the improved dysphagia varied among the articles. Additionally, some studies displayed fewer post-operative complications, such as choking and vocal hoarseness, among those treated with tracheal traction exercises.
Discussion: Dysphagia is a common and undesirable outcome following anterior cervical fusion and discectomy. Though the number of studies to analyze is limited, TTE may show promise in lessening dysphasia severity after ACDF.
Embargo Period
6-3-2026
Included in
The Use of Tracheal Traction Exercises to Prevent Post-operative Dysphagia Following Anterior Cervical Discectomy and Fusion
Philadelphia, PA
Introduction: Dysphagia is a commonly reported complication following anterior cervical disc fusion (ACDF). Some of the risk factors that increase dysphagia incidence include elevated BMI, smoking, female gender, and diabetes mellitus type 2. Treatment with methylprednisone administration and manipulation of endotracheal cuff pressures has been correlated with milder dysphagia in the intraoperative and early post-operative period; however, long-term differences between the control and treatment groups have not been statistically significant. Tracheal traction exercises are of emerging interest for treating ACDF patients with dysphagia. The purpose of this systematic review is to explore the outcome of the use of pre-operative tracheal traction exercises to reduce the incidence of or diminish the length of dysphagia among ACDF patients.
Methods: Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, observational studies were identified and collected for a systematic review. Inclusion criteria required discussion of anterior cervical discectomy and fusion, tracheal traction exercises, and dysphagia. Dysphagia was graded using various universal scoring systems, including the Bezaz Dysphagia Scale, Modified Dysphagia Scoring System, and Visual Analog Scale. Methodological index for non-randomized studies (MINORS) criteria were calculated to evaluate potential bias and the validity of the studies being analyzed. All studies included in this scoping review were evaluated using the comparative scoring system.
Results: In the preliminary search of Cochrane, scopus, embase, and PubMed, 1501 articles were identified. Of the analyzed articles, 1492 were excluded due to irrelevance to the scope of our study; of the 9 remaining, only 5 were available and reviewed tracheal traction. The MINORS criteria scoring placed all of the studies in the moderate category with scores between 15-22. Of the included articles, four of five showed lower scores, indicating less severe or no dysphagia with TTE compared to no treatment. The timing of the improved dysphagia varied among the articles. Additionally, some studies displayed fewer post-operative complications, such as choking and vocal hoarseness, among those treated with tracheal traction exercises.
Discussion: Dysphagia is a common and undesirable outcome following anterior cervical fusion and discectomy. Though the number of studies to analyze is limited, TTE may show promise in lessening dysphasia severity after ACDF.