A Patient’s guide to Adult Speech and Language Therapy Swallowing and Voice after Anterior Cervical Spine Surgery

• Anterior refers to the approach the surgeon will use to perform the surgery i.e. an incision will be made to the front of the neck.
• Cervical spine refers to the vertebrae (bones) at the top of your spine. Your surgery will involve one or more of these bones.
• In order to gain access to the spine, the food pipe (oesophagus) and wind pipe (trachea) will be retracted so they are out of the way.
• The surgeon will discuss your specific operation in more detail but may involve removal of a disc, replacement with a bone graft as well as potentially a fixation plate to add stability.

• Pain from the surgery
• Swelling inside the throat which can increase further on days 2 and 3 post surgery
• Damage to the nerves that control movement for voice and swallowing
• Reduced movement due to wearing a neck collar if required

Swallowing

• A sensation of food or drink ‘sticking’ in the throat due to the build-up of residues
• Pain on swallowing food or drink
• Throat clearing or coughing which can be a sign food or drink is going down the wrong way towards the lungs
• A ‘wet’ or gurgly voice due to material sitting on the vocal cords
• Difficulties with capsules and other medications

Voice

• A hoarse, husky, breathy or weak voice quality when talking
• Fatigue and discomfort when talking for long periods

Mild symptoms are common and resolve within a few weeks. However, there are occasions where more significant symptoms require therapy to improve.

SLT provide a service at the Royal National Orthopaedic Hospital to support those that experience swallowing and voice difficulties. This may include:

Swallowing

• Clinical assessment of eating and drinking at bedside
• Advice regarding specific diet and fluid recommendations to maximise  safety and comfort with eating and drinking
• Further investigation of symptoms reported may be required such as  an x-ray (Videofluoroscopy) or a test with a camera (Fibreoptic Endoscopic Evaluation of Swallow)
• Provision of additional exercises or strategies to rehabilitate or compensate for difficulties

Voice

• Perceptual assessment of voice
• Provision of strategies to promote good vocal hygiene and aid recovery
• Referral on to specialist voice services including ENT if indicated

The following general strategies might also be beneficial initially post-surgery:

• Eat and drink sitting upright with a slow pace  
• Choose softer options from menus and add extra sauces to moisten  food
• If swallowing tablets is painful speak to your nurse/medical team to see  if medications can be provided in alternative forms e.g. liquids
• Maintain a good fluid intake to help protect and allow your vocal cords  to recover

If you have any further queries or want to discuss your specific difficulties prior to being admitted for your surgery then please get in touch. Adult Speech and Language Therapy Department, Royal National Orthopaedic Hospital.

Telephone: 0208 909 5466.