REVIEW ARTICLE Dysphagia Associated with Cervical Spine and Postural Disorders Soultana Papadopoulou • Georgios Exarchakos • Alexander Beris • Avraam Ploumis Received: 30 January 2013 / Accepted: 11 July 2013 / Published online: 20 August 2013 Ó Springer Science+Business Media New York 2013 Abstract Difficulties with swallowing may be both per- sistent and life threatening for the majority of those who experience it irrespective of age, gender, and race. The purpose of this review is to define oropharyngeal dysphagia and describe its relationship to cervical spine disorders and postural disturbances due to either congenital or acquired disorders. The etiology and diagnosis of dysphagia are analyzed, focusing on cervical spine pathology associated with dysphagia as severe cervical spine disorders and postural disturbances largely have been held accountable for deglutition disorders. Scoliosis, kyphosis–lordosis, and osteophytes are the primary focus of this review in an attempt to elucidate the link between cervical spine dis- orders and dysphagia. It is important for physicians to be knowledgeable about what triggers oropharyngeal dys- phagia in cases of cervical spine and postural disorders. Moreover, the optimum treatment for dysphagia, including the use of therapeutic maneuvers during deglutition, neck exercises, and surgical treatment, is discussed. Keywords Cervical spine Á Oropharyngeal dysphagia Á Scoliosis Á Kyphosis–lordosis Á Deglutition Á Deglutition disorders The process of deglutition is an automatic response to the presence of liquids, semisolids, or solids in the oral cavity and is based on the manipulation of food. People generally are able to maintain a healthy condition of eating and drinking. On the contrary, the quality of life of those who experience swallowing difficulties is poor. The preparation and completion of swallowing are concluded in the oral, pharyngeal, and esophageal stages, and, as a consequence, unsuccessful or incomplete deglutition in any or all stages results in the condition known as dysphagia [1]. Dysphagia refers to a disorder that occurs at any stage of eating, starting from the detection of food in the buccal cavity up to the manipulation and swallowing of food of every consistency. Oropharyngeal dysphagia is caused by mainly structural or neuromotor abnormalities in the oral cavity, oropharynx, velopharynx, hypopharynx, and upper esophageal sphincter [2]. The most frequent causes of dysphagia are structural and functional disorders, lesions in the central nervous system (CNS) and peripheral nervous system (PNS), and psycho- genic reasons. Oropharyngeal dysphagia has been reported as a complication of degenerative disorders, after surgery, respiratory disorders, chemoradiation, disorders in the metabolism that may lead to malnourishment and dehy- dration, and esophageal dysfunction. Finally, osteophytes of the cervical spine, malignancies, or simply dysphagia occurring in old age [3] due to normal age-related changes can cause deglutition disorders. Apart from neurological disorders, chemoradiation for head and neck tumors is responsible for oropharyngeal dysphagia which is both a prevalent symptom and a side effect of prescription drugs and chemotherapy. Finally, dysphagia is often seen in the elderly [4]. From 40 to 70 % of stroke patients develop aspiration problems and silent aspiration occurs in 40 % of dysphagic patients [5]. S. Papadopoulou (&) Department of Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece e-mail: soultpap@yahoo.gr G. Exarchakos Department of Otorhinolaryngology, University of Ioannina Medical School, Ioannina, Greece A. Beris Á A. Ploumis Departments of Orthopaedic Surgery and Physical Medicine and Rehabilitation, University of Ioannina Medical School, Ioannina, Greece 123 Dysphagia (2013) 28:469–480 DOI 10.1007/s00455-013-9484-7