Altered pharyngeal structure and dynamics among patients with cervical kyphosis
Bibliographic record
Abstract
Objectives/Hypothesis Deformities of the anterior cervical spine are an established cause of dysphagia. Whereas osteophytes and spinal fusion hardware have been reported to alter bolus flow and contribute to swallowing dysfunction, the relationship between abnormal spine curvature and swallowing dysfunction is not established. The purpose of this investigation was to evaluate the association between cervical kyphosis and objective measures of swallowing dysfunction on videofluoroscopy. Study Design Case‐control study of patients presenting to tertiary dysphagia center. Methods All videofluoroscopic swallow studies (VFSS) performed at our institution, between August 1, 2014, and August 1, 2015, were retrospectively reviewed to identify patients with abnormal cervical kyphosis, according to Cobb and Jackson angle measurements. Patients with kyphosis were age‐ and gender‐matched to persons without kyphosis. VFSS and demographic parameters were collected and compared between groups. Results Thirty‐six patients with cervical kyphosis exceeding two standard deviations (SD) beyond established age‐specific normal ranges were identified. The mean age of the entire cohort was 61.6 (SD ±19.1) years. Mean pharyngeal area was 3.34 cm 2 greater in kyphosis patients compared to controls (95% confidence interval [CI]: 0.47‐5.21 cm 2 ; P = .0007). This was associated with increased hypopharyngeal transit time (0.57 seconds, 95% CI: 0.045‐1.09 seconds, P = .034), and higher prevalence of penetration ( P = .014). There was no significant difference in the pharyngeal constriction ratio (PCR), a surrogate measure of pharyngeal strength ( P = .83). Conclusions Patients with cervical spine kyphosis have a significantly dilated pharynx ( P = .0007), elongated hypopharyngeal transit time ( P = .034), and worsened penetration aspiration scores ( P = .021). Absence of a difference in PCR suggests adequate compensation as a group. Level of Evidence 3b. Laryngoscope , 127:1832–1837, 2017
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".