Swallowing disorders related to vertebrogenic dysfunctions

Abstract

Objective: Functional disorders of the gastrointestinal tract are a frequent cause of problems reported by patients to practicing specialists in a number of fields. Our study was focused on swallowing disorders (dysphagias) in the region of the esophagus related to disorders of the motor system in the region of cervical and thoracic spine. Patient group and methods: The monitored group consisted of 48 patients, of which 6 men and 42 women (ranging from 22 to 71 years of age). The patients were included in the group for pain in the region of the cervical or thoracic spine and concomitant difficulty swallowing of non-obstructive nature described as the feeling of stuck food or liquid. We used dynamic scintigraphy of the esophagus to examine the swallowing act in order to evaluate the mean transit time (MTT) of the passage of liquid through the esophagus. The patients were treated with rehabilitation for a period of 2-3 weeks. Results: Radio-isotope measurement of esophageal motility showed a statistically significant reduction in MTT from the mean value of 10.3 seconds to 7.6 seconds (p = 0.000129). Significant improvement in the following parameters was recorded for the patients with a decrease in the MTT value: degree of dysphagia, intensity of pain in the C and Th regions of the spine, reduction in pathological findings in the region of the lower cervical spine, of the C/Th transition, the first rib and the proximal thoracic spine, reduced finding of the trigger points in the region of the m. sternocleidomastoideus and mm. scaleni. Conclusions: We found important links between non-obstructive dysphagias, the length of MTT and the motor system disorders. Rehabilitation had a positive effect on pain, reduced the incidence of clinical findings and resulted in the suppression of difficulty swallowing symptoms. Dynamic scintigraphy of the esophagus allowed for objective evaluation of the therapeutic effect.