Adult speech and language therapy services

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What is anterior cervical spine surgery?

• Anterior refers to the approach that the surgeon will take when he performs the operation. In your case this means he will be operating from the front of your neck: just to one side of your voice box (which is behind your Adam’s apple).
• Cervical refers to the vertebrae (bones) at the top of your spine: the cervical spine.
• There are seven cervical vertebrae running from the bottom of your skull to just between your shoulder blades.
• You will be having surgery on one or more of these vertebrae.
• Your surgeon will explain your individual operation to you.

Are swallowing problems common after this type of surgery?

• Yes: during the first few days swallowing problems are very common.
• It is unusual for these swallowing problems to continue beyond 6 to 8 weeks after surgery.
• You may be at greater risk of developing swallowing problems if your surgery involves two or more vertebrae.
• Difficulties swallowing hard, dry or crumbly foods (eg toast, pastry, apples, cakes, crisps, biscuits).
• Difficulties swallowing foods with skins or husks (eg grapes, tomatoes, peas, beans, sweetcorn).
• Difficulties with mixed consistencies (eg soluble medicine which can be gritty, fruit juice or soups with bits, cereals floating in milk).
• Difficulty triggering a strong swallow.
• Coughing after eating and drinking.
• A sensation of food sticking in the throat.

What causes these swallowing difficulties?

• Bruising around throat/neck.
• Swelling/inflammation inside your throat which may cause pressure against your gullet/swallowing tube (oesophagus).
• Temporary swelling of the swallow muscles.
• Scar formation.
• Pain on swallowing.
• For some, the position of screws/plate or wearing a hard collar may interfere with swallowing in the early weeks.
• If your surgery involves grafting then movement of the graft may affect swallowing.

The nursing and medical staff will be there to help you with any problems you may experience.

How can your speech and language therapist (SALT) help you?

• S/he will assess your eating and drinking. It might be necessary to take an x-ray of your swallow to identify any problems you are experiencing.
• Following assessment the SALT will offer advice on the best way to eat and drink safely.

What can help?

• Sit upright for all eating and drinking.
• Don’t rush drinks or meals.
• Avoid distractions so you can concentrate on swallowing.
• Choose soft, easy swallow options from the menu – eg porridge, yoghurt, crustless sandwiches with soft, moist fillings, scrambled eggs, soft pasta with smooth sauces etc).
• Add extra gravy, sauce, custard etc.
• Sometimes pureed food may be necessary for a few days immediately after surgery.
• Avoid mixed consistencies eg soups and juices with bits in.
• Sometimes it may be necessary to drink thickened drinks such as smoothies.
• If swallowing is painful you may need to take your pain killers about 20 minutes before eating or drinking.
• If you find swallowing tablets difficult then ask your GP to prescribe them in a liquid or crushable form.

What will happen when you go home?

• If your swallowing problems are persisting your SALT will refer you to a local speech and language therapist for follow up or see you in outpatients at The Princess Royal Hospital.
• Your SALT will give you written advice about how best to continue with safe eating and drinking.
• Your SALT will telephone you at home to see how you are managing and you can phone him/her at any time after discharge if you have any worries about your swallowing.

Feedback

We appreciate hearing what we are doing well and where we could make improvements. Please send your comments addressed to:

Mandy McLeod, Speech & Language Therapy Manager (Adults)
Room 108, Downsmere, Princess Royal Hospital, Lewes Road, Haywards Heath, West Sussex, RH16 4EX

The Patient Advice and Liaison Service (PALS)

The Patient Advice and Liaison Service (PALS) can give you information, help and advice with any problems you may have while using our services. You can contact the PALS team by:

Telephone between 10am and 4pm on 01273 664973/664511 or 01444 448678
or by email:[email protected]