{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T17:19:45Z","timestamp":1764350385384,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2016,5,11]]},"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The incidence of severe dysphagia requiring gastrostomy tube (GT) placement following operative fixation of traumatic cervical spine fractures is unknown. Risk factors for severe dysphagia are not well identified and GT placement is often delayed due to the belief that it will resolve quickly. We hypothesized that patient and clinical factors could be used to predict severe dysphagia requiring GT placement in this population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective multicenter review of all adult patients requiring operative fixation of cervical spine fractures was performed. Data on demographics, injury severity score, presence of spinal cord injury, operative approach, presence of severe traumatic brain injury, and the need and timing of tracheostomy and GT were collected. The timing, number and results of formal speech, and language pathology examinations were also recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>243 patients underwent cervical spine fixation for traumatic fractures, of which 72 (30%) required GT placement. Patients requiring gastrostomy were significantly older, 54 versus 45\u2005years (p=0.002), and had higher injury severity scores at 24 versus 18 (p&lt;0.0001). Tracheostomy was strongly associated with severe dysphagia; GT was required in 83% of patients who underwent tracheostomy versus 5% of those who did not require tracheostomy. 50% of patients underwent tracheostomy and GT on the same day after injury, with the remaining patients having an average of 9\u2005days delay between procedures. The need for gastrostomy placement was also higher in patients undergoing combined operative approach versus anterior or posterior approach alone (p=0.02). There were no GT-related complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Severe dysphagia requiring GT placement occurs commonly (30%) in patients who undergo operative fixation of cervical spine fractures. Gastrostomy placement was delayed in 50%. Tracheostomy was strongly associated with the need for GT placement. Earlier GT placement, especially in patients requiring tracheostomy, would improve patient care and disposition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2016-000001","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T05:17:46Z","timestamp":1502428666000},"page":"e000001","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Severe dysphagia requiring gastrostomy following cervical spine fracture fixation"],"prefix":"10.1136","volume":"1","author":[{"given":"Joanelle A","family":"Bailey","sequence":"first","affiliation":[{"name":"Rutgers University\u2014New Jersey Medical School, Newark, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F","family":"Lavery","sequence":"additional","affiliation":[{"name":"Rutgers University\u2014New Jersey Medical School, Newark, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M","family":"Adams","sequence":"additional","affiliation":[{"name":"Divisions of Trauma and Surgical Critical Care, Department of Surgery at Morristown Memorial Hospital, Morristown, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S","family":"Livingston","sequence":"additional","affiliation":[{"name":"Rutgers University\u2014New Jersey Medical School, Newark, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lou","family":"DiFazio","sequence":"additional","affiliation":[{"name":"Divisions of Trauma and Surgical Critical Care, Department of Surgery at Morristown Memorial Hospital, Morristown, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H","family":"Livingston","sequence":"additional","affiliation":[{"name":"Rutgers University\u2014New Jersey Medical School, Newark, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,8]]},"reference":[{"key":"2025082410450741000_1.1.e000001.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2006.02.024"},{"key":"2025082410450741000_1.1.e000001.2","unstructured":"Lee JY , Lim MR , Albert TJ . Dysphagia after anterior cervical spine surgery: pathophysiology, incidence, and prevention. Cervical Spine Res Soc 2005. http:\/\/www.csrs.org\/wp-content\/uploads\/2014\/06\/dysphagia-outcome-study.pdf (accessed May 28, 2016).http:\/\/www.csrs.org\/wp-content\/uploads\/2014\/06\/dysphagia-outcome-study.pdf"},{"key":"2025082410450741000_1.1.e000001.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2014.03.030"},{"key":"2025082410450741000_1.1.e000001.4","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1731-8"},{"key":"2025082410450741000_1.1.e000001.5","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181d81a96"},{"key":"2025082410450741000_1.1.e000001.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000129100.59913.EA"},{"key":"2025082410450741000_1.1.e000001.7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1354253"},{"key":"2025082410450741000_1.1.e000001.8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.3171\/2013.6.SPINE121134","article-title":"Dysphagia following combined anterior-posterior cervical spine surgeries","volume":"19","author":"Chen","year":"2013","journal-title":"J Neurosurg Spine"},{"key":"2025082410450741000_1.1.e000001.9","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1302\/0301-620X.95B7.31029","article-title":"Dysphagia following anterior cervical spinal surgery: a systematic review","volume":"95-B","author":"Cho","year":"2013","journal-title":"Bone Joint J"},{"key":"2025082410450741000_1.1.e000001.10","doi-asserted-by":"crossref","first-page":"E528","DOI":"10.1097\/BRS.0b013e31828a2992","article-title":"Postoperative prevertebral soft tissue swelling does not affect the development of chronic dysphagia following anterior cervical spine surgery","volume":"38","author":"Khaki","year":"2013","journal-title":"Spine"},{"key":"2025082410450741000_1.1.e000001.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2011.07.004"},{"key":"2025082410450741000_1.1.e000001.12","doi-asserted-by":"crossref","unstructured":"Wu B , Song F , Zhu S . Reasons of dysphagia after operation of anterior cervical decompression and fusion. J Spinal Disord Tech. Published Online First: Oct 10, 2014. doi:10.1097\/BSD.0000000000000180","DOI":"10.1097\/BSD.0000000000000180"},{"issue":"3","key":"2025082410450741000_1.1.e000001.13","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s12262-015-1227-6","article-title":"Percutaneous endoscopic gastrostomy: technical problems, complications, and management","volume":"77","author":"Yuruker","year":"2015","journal-title":"Indian J Surg"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2016-000001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:45:13Z","timestamp":1756057513000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2016-000001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,6,8]]},"published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1136\/tsaco-2016-000001"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2016-000001","relation":{},"ISSN":["2397-5776"],"issn-type":[{"type":"electronic","value":"2397-5776"}],"subject":[],"published":{"date-parts":[[2016,6]]}}}