Skip to main content
Log in

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

  • Review Article
  • Published:
Dysphagia Aims and scope Submit manuscript


Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multiengine literature search identified 137 articles of which five were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low-level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies; however, there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Shem KL, Castillo K, Wong SL, Chang J, Kao MC, Kolakowsky-Hayner SA. Diagnostic accuracy of bedside swallow evaluation versus videofluoroscopy to assess Dysphagia in individuals with tetraplegia. PM and R. 2012;4:283–9.

    PubMed  Google Scholar 

  2. Kirshblum S, Johnston MV, Brown J, O’Connor KC, Jarosz P. Predictors of dysphagia after spinal cord injury. Arch Phys Med Rehabil. 1999;9:1101–5.

    Google Scholar 

  3. Brady S, Miserendino R, Statkus D, Springer T, Hakel M, Stambolis V. Predictors to dysphagia and recovery after cervical spinal cord injury during acute rehabilitation. J Appl Res. 2004;4:1–11.

    Google Scholar 

  4. Gordan W, Spivak-David D, Adornato V, Dale B, Brougham R, Georgeadis AC, Gassaway J. SCIRehab project series: the speech language pathology taxonomy. J Spinal Cord Med. 2009;32:307–18.

    PubMed  PubMed Central  Google Scholar 

  5. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41.

    PubMed  Google Scholar 

  6. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, CARE Group. The CARE Guidelines: consensus-based clinical case reporting guideline development. Glob Adv Health Med. 2013;2:38–43.

    PubMed  PubMed Central  Google Scholar 

  7. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M. STROBE initiative (2014) strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg. 2014;12:1500–24.

    PubMed  Google Scholar 

  8. Martin RE, Neary MA, Diamant NE. Dysphagia following anterior cervical spine surgery. Dysphagia. 1997;12:2–10.

    CAS  PubMed  Google Scholar 

  9. Martino R, Beaton D, Diamant NE. Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. Dysphagia. 2010;25:26–34.

    PubMed  Google Scholar 

  10. Bulow M, Speyer R, Baijens L, Woisard V, Ekberg O. Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction. Dysphagia. 2008;23:302–9.

    PubMed  Google Scholar 

  11. Boczko F, McKeon S. Dysphagia: age is no barrier. Clin Geriatr. 2005;13:15.

    Google Scholar 

  12. Cumpston EC, Bock JM. Severe transient pharyngeal paralysis following C2 fracture repair. Ann Otol Rhinol Laryngol. 2015;124:598–602.

    PubMed  Google Scholar 

  13. Dettling SD, Morscher MA, Masin JS, Adamczyk MJ. Cranial nerve IX and X impairment after a sports-related Jefferson (C1) fracture in a 16-year-old male: a case report. J Pediatr Orthop. 2013;33:e23–7.

    PubMed  Google Scholar 

  14. Shin DU, Sung JK, Nam KH, Cho DC. Bilateral internal superior laryngeal nerve palsy of traumatic cervical injury patient who presented as loss of cough refex after anterior cervical discectomy with fusion. J Korean Neurosurg Soc. 2012;52:264–6.

    PubMed  PubMed Central  Google Scholar 

  15. Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81:929–69.

    CAS  PubMed  Google Scholar 

  16. Daniels AH, Riew KD, Yoo JU, Ching A, Birchard KR, Kranenburg AJ, Hart RA. Adverse events associated with anterior cervical spine surgery. J Am Acad Orthop Surg. 2008;16:729–38.

    PubMed  Google Scholar 

  17. Carucci LR, Turner MA, Yeatman CF. Dysphagia secondary to anterior cervical fusion: radiologic evaluation and findings in 74 patients. AJR Am J Roentgenol. 2015;204:768–75.

    PubMed  Google Scholar 

  18. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010;25:323–33.

    PubMed  PubMed Central  Google Scholar 

  19. Thibault-Halman G, Casha S, Singer S, Christie S. Acute management of nutritional demands after spinal cord injury. J Neurotrauma. 2011;28:1497–507.

    PubMed  PubMed Central  Google Scholar 

  20. Khaki F, Zusman NL, Nemecek AN, Ching AC, Hart RA, Yoo JU. Postoperative prevertebral soft tissue swelling does not affect the development of chronic dysphagia following anterior cervical spine surgery. Spine. 2013;38:E528–32.

    PubMed  Google Scholar 

  21. Steele CM, Alsanei WA, Ayanikalath S, Barbon CE, Chen J, Cichero JA, Coutts K, Dantas RO, Duivestein J, Giosa L, Hanson B, Lam P, Lecko C, Leigh C, Nagy A, Namasivayam AM, Nascimento WV, Odendaal I, Smith CH, Wang H. The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia. 2015;30:2–26.

    PubMed  Google Scholar 

  22. Johnson DN, Herring HJ, Daniels SK. Dysphagia management in stroke rehabilitation. Curr Phys Med Rehabil Rep. 2014;2:207–18.

    Google Scholar 

  23. Pedram M, Castagnera L, Carat X, Macouillard G, Vital JM. Pharyngolaryngeal lesions in patients undergoing cervical spine surgery through the anterior approach: contribution of methylprednisolone. Eur Spine J. 2003;12:84–90.

    CAS  PubMed  Google Scholar 

  24. Zhong ZM, Jiang JM, Qu DB, Wang J, Li XP, Lu KW, Xu B, Chen JT. Esophageal perforation related to anterior cervical spinal surgery. J Clin Neurosci. 2013;20:1402–5.

    PubMed  Google Scholar 

  25. Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128:305–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. OCEBM levels of evidence working group. The oxford 2011 levels of evidence. Oxford centre for evidence-based medicine.

Download references


We gratefully acknowledge Jessica Babineau, MLIS information specialist from Toronto Rehabilitation Institute, University Health Network, for her assistance with the development and execution of the literature search. The views expressed do not necessarily reflect those of the Ministry.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Teresa J. Valenzano.

Ethics declarations

Conflicts of Interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Valenzano, T.J., Waito, A.A. & Steele, C.M. A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population. Dysphagia 31, 598–609 (2016).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: