Working to Eliminate Common Side Effects of Spine Surgery

Northwestern Medicine
Orthopaedics December 31, 2013
Even after successful surgery to repair pinched nerves or herniated discs in the neck, patients often deal with a pair of common side effects — difficulty swallowing and hoarseness.
Alpesh A. Patel, MD in the operating roomNorthwestern Medicine® orthopaedic spine surgeon Alpesh A Patel, MD, FACS, is researching the best ways to assess and reduce the complications of dysphagia (difficulty swallowing) and dysphonia (changes in voice production and sound).

“While these are common complaints from patients after surgery, I found there is only limited research on dysphagia and dysphonia,” said Patel, co-director of the Northwestern Spine Center and chief of orthopaedic spine surgery at Northwestern Memorial Hospital. “I wanted to assess a questionnaire that could give us a relatively simple baseline measure for patients before and after surgery, a tool which can accurately chart their recovery.”
The voice and throat can be affected during surgery for cervical disc herniations or spinal stenosis.
Surgeons enter the space between the vertebrae through a small incision in the front of the neck. The surgical path crosses closely to the nerves and tissues that support both swallowing and speech. Even in the best of hands, patients can have trouble afterwards.
Working with Northwestern Medicine’s Jason Savage, MD, and Wellington Hsu, MD, the physicians found the traditional tools used to measure outcomes on dysphagia and dysphonia were both inaccurate and time-consuming for patients and clinicians. The newly-developed Eating Assessment Tool and the Voice Handicap Index are given before surgery and then at various intervals for up to one year after the surgery.
“We are working with participants in the study to establish a baseline and then, over the course of a year, gauge their improvement,” said Patel, who is also an associate professor of orthopaedic surgery at Northwestern University Feinberg School of Medicine. “Our hope is that ultimately our patients receive greater relief of pain from their pinched nerves or herniated discs but also from the common side effects of surgical treatment.”
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