Role of O-C2 angle in the development of dysphagia in patients with halo-vest fixation
Role of O-C2 angle in the development of dysphagia in patients with halo-vest fixation
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DOI：
10.1186/s12891-020-3155-2
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发表时间：
2020-02-28
影响因子：
2.3
通讯作者：
Ebihara, Satoru
中科院分区：
文献类型：
--
作者：
Miyagi, Midori;Takahashi, Hiroshi;Ebihara, Satoru
背景吞咽困难是接受头环背心支具治疗的患者最严重的并发症之一。然而，晕圈背心固定导致吞咽困难的原因尚不清楚。因此，我们调查了接受光环背心支具治疗的患者的吞咽困难和颈椎排列困难的发生率，以及来自病历的临床数据。方法对49例头环背心内固定术患者的临床资料进行回顾性分析。颈椎侧位X线片测量枕骨(O)-C2角、C2-C6角和咽入口角。分析这些参数对吞咽困难发生率和严重程度的影响。结果头环背心固定期间发生吞咽困难13例(32%)，吞咽困难组年龄和住ICU时间均大于无吞咽困难组(p=0.044和0.013)。吞咽困难组O-C2角较小(p=0.016)。经多因素Logistic分析，体重指数、ICU住院时间和O-C2角仍是吞咽困难发生率的独立危险因素。Spearman等级相关分析显示，ICU停留时间与食物摄入水平评分(FIRS)呈负相关(p=0.026)，O-C2角与FIRS呈正相关(p=0.008)。结论O-C2角与头环背心固定所致吞咽困难的发生率及严重程度有关。
Background Dysphagia is one of the most serious complications in patients treated with a halo-vest brace. However, the cause of dysphagia development by halo-vest fixation is not yet clear. We therefore investigated the incidence of dysphagia and cervical alignment as well as clinical data from medical charts in patients treated with a halo-vest brace. Methods We retrospectively reviewed clinical data from the medical charts of 49 patients who had undergone halo-vest fixation. Occipito (O)-C2 angle, C2-C6 angle, and pharyngeal inlet angle were assessed by lateral plain X-rays of the cervical spine. The impacts of these parameters on incidence and severity of dysphagia were analyzed. Results Thirteen patients (32%) suffered from dysphagia during halo-vest fixation, and age and length of intensive care unit (ICU) stay were greater in the dysphagia group (p = 0.044 and 0.013, respectively) than in those who did not develop dysphagia. O-C2 angle was smaller in the dysphagia group (p = 0.016). After multivariate logistic analysis, body mass index, ICU stay, and O-C2 angle remained as independent risk factors related to incidence of dysphagia. Spearman rank correlation showed a negative correlation between ICU stay and Food Intake Level Scale (FILS) (p = 0.026), and a positive correlation between O-C2 angle and FILS (p = 0.008). Conclusion This study suggested that O-C2 angle is related to both incidence and severity of dysphagia due to halo-vest fixation.