Cervical disc disease and difficulty swallowing – cervicogenic dysphagia

Ross A. Hauser, MD. 

Treating Cervical Spine Instability is treating swallowing difficulties

When a patient comes into our clinic with problems of swallowing difficulties, the swallowing difficulties are usually not a problem in isolation. The patient will describe a medical history as bulging discs in the neck, a course of cortisone injections, advancing neck pain, and reduction in neck motion

When a patient comes into our clinic with problems of swallowing difficulties, the swallowing difficulties are usually not a problem in isolation. While patients may tell us of their swallowing difficulties, most come in with primary complaints of neck pain or neck instability, whiplash associated disorders, or post-concussion syndrome. Swallowing difficulties may be accompanied by headaches, dizziness, hearing problems, severe muscle spasms in the neck, ear filling to name but just a few symptoms.

In this article, we will present research, clinical observation, and patient outcomes to suggest that treating instability in the cervical spine with regenerative proliferative injections can help many patients with swallowing difficulties.

A link between cervical spine instability to swallowing difficulties used to be rarely acknowledged and for the most part ignored.

In 2013, noted Croatian musculoskeletal researcher Vjekoslav Grgić published a paper linking cervical spine instability to swallowing difficulties. (1) He also noted that this association was rarely acknowledged and for the most part ignored. We are going to present research below that takes us to 2020 and see how much has changed in 7 years. Surprisingly, it will be not much.

Here is Dr. Grgić’s review summary. See if this sounds familiar to your own case:

“Cervical spine disorders which can cause swallowing difficulties (cervicogenic dysphagia) are chronic multisegmental/musculoskeletal dysfunction (dysfunction=functional blockade) of the facet joints, changes in physiological curvature of the cervical spine, degenerative changes (anterior osteophytes (bone spurs), anterior disc herniation, osteochondrosis, osteoarthritis), inflammatory rheumatic diseases, diffuse idiopathic skeletal hyperostosis (extensive amount of calcification that occurs within the spinal ligaments in the condition), injuries, conditions after anterior cervical spine surgery, congenital malformations and tumors.

According to our clinical observations, degenerative changes in the cervical discs and facet joints and chronic musculoskeletal dysfunction of the cervical spine facet joints are disorders that can cause swallowing difficulties.

However, these disorders have not been recognized enough as the causes of dysphagia and they are not even mentioned in differential diagnosis.

It was clear that the patient’s swallowing difficulties were coming from the cervical spine

In this case review from the New York Chiropractic & Physiotherapy Centre, reported in the Clinical medicine insights. Case reports, (2) the doctors acknowledged that when someone has swallowing difficulties this could be “salivary secretory disorders, poor oral motor coordination, neuromuscular weakness, neurodegenerative diseases, stroke, and structural changes, can result in swallowing disorders.” But here they presented a case that they found astounding enough to publish the results. What made this case so astounding? It was clear that the patient’s swallowing difficulties were coming from the cervical spine.

Listen to the case:

How did this happen?

The conclusion of all this?

Cervicogenic dysphagia caused by cervical spine/neck instability is not underestimated. In this case chiropractic care was able to help eliminate the swallowing difficulties. As we will discuss below in our office we will employ chiropractic techniques with Dr. Brian Hutcheson as well as Prolotherapy injections to help hold the adjustments in place and to provide strength and stability to the spinal ligaments.

C2 malrotation can cause swallowing difficulties

In this x-ray from one of our patients we can display a C2 malrotation. The dotted center line represents where the center of the C2 should be. We see that the C2 is shifter far over. Restoring the C2 to its natural position can alleviate swallowing difficulties as well as many symptoms attributed to cervical spine instability.

In this x-ray from one of our patients we can display a C2 malrotation. The dotted center line represents where the center of the C2 should be. We see that the C2 is shifter far over. Restoring the C2 to its natural position can alleviate swallowing difficulties as well as many symptoms attributed to cervical spine instability.

Next is a video from Ross Hauser, MD., where the cervical spine instability is associated with cervical nerve dysfunction.


In this video Ross Hauser, MD explains the functional dynamics and possible solutions to swallowing difficulties.

Video Summary Transcript

Swallowing involves many of the cranial nerves:

All these nerves run around the front of the cervical spine ‘s vertebrae, especially at C1 – C2. When somebody does have cervical instability it’s normally because of excessive stretching of the ligaments in the back of the neck. When these ligaments are weak, injured or torn what happens is the cervical vertebrae move forward when they move forward they can impair the nerve’s impulse through these various nerves. More symptoms such as choking on excretions, spit or mucus can occur. Difficulty in talking may occur as if your muscles are too weak to talk.

In our office, we use injection techniques like Prolotherapy to help stabilize the cervical spine. In many patients, we can reverse these symptoms by stabilizing the cervical spine and restoring the neck’s natural curve.  This is explained below.


Even though I have neck problems I was sent for an endoscopy – Esophagogastroduodenoscopy

Often we will hear a story, it goes something like this:

I have had chronic problems in my neck. One of my problems is that, over time, I have found it more difficult to swallow foods. I was sent for an endoscopy to rule out digestive problems, I have already had enough x-rays and MRI to rule out cancer. I know the swallowing difficulty is from my neck problems. My diet over the last few months has increasingly become a steady menu of soups and broths. I feel something is stuck in my throat, I belch a lot, I get anxious about eating for fear of choking on my food. I also find that many times when I try to swallow I feel like I am going to faint or pass out. 

My endoscopy was inconclusive

“If she held her head still, she was able to swallow”


Swallowing difficulties and bone spurs

There is not much research in the medical community that focuses solely on swallowing difficulties in relation to cervical spine instability. But there are many clues that clearly makes a connection.

In the April 2017 issue of the Journal of bodywork and movement therapies, a combined team of researchers from the University of Padova and the University of Bologna in Italy documented a case history of a young female patient with swallowing difficulties.(3)

In this case study, the doctors performed an MRI that revealed an anterior C5-C6 disc protrusion associated with a lesion of the anterior longitudinal ligament. The barium radiograph showed a small anterior cervical osteophyte (bone spur) at the C6 level.

Conclusion: Diagnostic hypothesis was a combination of cervical disc dysfunction associated with C6 osteophyte and reduced functional stability AND a ligament tear.

Searching for clues when surgery and treatment fail to correct swallowing difficulties.

We have seen many patients with degenerative cervical spinal disease who can no longer tolerate continued high dosage narcotic painkillers or the anxiety or depression trip after trip to specialist after specialist is causing them. One clue that we may be able to help these people with their challenges including that of swallowing difficulties is if you put them in a cervical collar, do they get relief? If the answer is yes, then the collar is providing the missing cervical neck instability.

We do see people with advanced degenerative cervical disc disease who have or had significant bone spur formation. Many of these patients have had surgery to remove the bone spurs, yet their swallowing difficulties remained. If it was not the bone spurs pressing on the esophagus, what could it be? Why do these people still have swallowing difficulties after surgery? Let’s find out.

Swallowing difficulties and Diffuse idiopathic skeletal hyperostosis – “an underappreciated phenomenon”

Similarly, Cervicogenic dysphagia can be brought on by diffuse idiopathic skeletal hyperostosis, (DISH) a condition where the cervical ligaments and their attachments to the vertebrae (the entheses)  undergo calcification and ossification. In general terms, the soft tissue has calcified or turned into bone spurs. The bone spurs cause esophageal obstruction. Aging patients, men more so than women are susceptible to swallowing difficulties related to diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis is a more common disorder than some doctors thought. Doctors in the Netherlands issued this warning in The Spine Journal:

“Diffuse idiopathic skeletal hyperostosis as a cause of dysphagia and/or airway obstruction may be an increasing and underappreciated phenomenon.”(4)

Diffuse idiopathic skeletal hyperostosis can be brought on by degenerative wear and tear, as mentioned above, as a result of age or overuse. As with any bone spur, bone spurs form to help stabilize a joint. Diffuse idiopathic skeletal hyperostosis develops to stabilize cervical instability by turning the soft tissue attachments that are failing, into bony attachments. This, unfortunately, distorts the cervical spine and leads to various cervical related symptoms beyond swallowing difficulties.

Swallowing difficulties can be a degenerative disorder of weakened cervical neck ligaments

Now let’s explore a March 2019 study in the medical journal Spine.(5) This research comes from the Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan. the goal of this study was to investigate whether cervical (neck) alignment is related to dysphagia in patients with cervical diffuse idiopathic skeletal hyperostosis.

This is what the researchers found puzzling:

So they looked at 5 patients with advanced dysphagia due to anterior cervical hyperostosis (bone spurs) who underwent bone removal, and five patients with mild symptoms who were only monitored.

What is this research telling us?

Swallowing difficulties: A problem of autonomic nervous system dysfunction?

Swallowing difficulty may also be due to autonomic nervous system dysfunction that may be caused by Barré-Lieou Syndrome, also known as posterior cervical sympathetic syndrome and cervicocranial syndrome. This can be a severely debilitating condition in which the autonomic nervous system of the head and neck area is not working correctly. In almost all patients we see, there is a link between cervical spine instability and the onset of Barré-Lieou Syndrome.

Swallowing is a very complex process that involves the mouth, throat, and esophagus. Many nerves and muscles affect the correct functioning of these parts, and while part of the process of swallowing is under voluntary control, much of it is involuntary. Cervical spine instability can affect both the voluntary and involuntary response.

MRI of the neck showing bulging discs at c5-c6 causing a narrowing of the subarachnoid space. The space between the arachnoid membrane and pia mater containing the cerebrospinal fluid and large blood vessels that supply the brain and spinal cord. The person in this MRI had neck pain, headaches, swallowing difficulties, sinusitis, balancing issues that were related to cervical spine instability.

MRI of the neck showing bulging discs at c5-c6 causing a narrowing of the subarachnoid space. The space between the arachnoid membrane and pia mater containing the cerebrospinal fluid and large blood vessels that supply the brain and spinal cord. The person in this MRI had neck pain, headaches, swallowing difficulties, sinusitis, balancing issues that were related to cervical spine instability.

Swallowing difficulties: A problem of age?

The muscles and support structures of the neck make for good swallowing function. As we age degenerative disease can affect the muscles, tendons, and ligaments that help us swallow.

A study in the journal Current Opinion in Otolaryngology & Head and Neck Surgery (6) suggests that surgeons and clinicians explore multidisciplinary perspectives and initiatives, (it is not just one thing causing the problem and you may need to explore “innovative” and multiple treatments).

One thing that the researchers suggest as innovative is swallowing exercises. This is to build up the muscular structure of the swallowing mechanism. To build up muscle you need strong tendons and ligaments. You have to deal with the problem of cervical instability.

Swallowing difficulties: A problem of posture?

In the medical journal Dysphagia, (7) researchers discussed the relationship between oropharyngeal (back of the throat) dysphagia and its relationship to cervical spine disorders and postural disturbances due to either congenital or acquired disorders.

They write: “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 (swallowing) disorders.”

“It is important for physicians to be knowledgeable about what triggers oropharyngeal dysphagia 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, (should be discussed with patients).”

Swallowing difficulties caused by the odontoid process of the axis because of C1/2 instability

A December 2019 paper from the New York Chiropractic & Physiotherapy Centre, New York Medical Group, Hong Kong, China was published in the journal Clinical medicine insights. Case reports.(8) The paper was titled: “Unusual Cause of Dysphagia in a Patient With Cervical Spondylosis.” What was the unusual cause? Cervical spine instability. Here is the unusual case presented:

“Given that causes of dysphagia differ from patient to patient, individualized treatment plans tailored toward patients’ specific conditions are needed. Here we present a case of an elderly woman with upper neck stiffness and dysphagia sought chiropractic treatment. Radiographic findings suggested cervical spondylosis with a vertical atlantoaxial subluxation. Following 20 sessions of chiropractic treatment, the patient experienced complete relief from neck problems and difficulty in swallowing.

Rhythmic swallowing movements are controlled by a central pattern-generating circuit of the brain stem. In this case, the brain stem could have been compressed by the odontoid process of the axis due to C1/2 instability.

Cervicogenic dysphagia is a cervical cause of difficulty in swallowing. Cervical complaints in the context of dysphagia are mostly under-estimated. A high degree of clinical suspicion is pivotal in timely intervention.”

In this case, results may have been achieved because the c1/c2 vertebrae were adjusted back into alignment.

Swallowing difficulties: TMJ Involvement with cervical instability

In the Journal of Oral and Maxillofacial Surgery: The official journal of the American Association of Oral and Maxillofacial Surgeons, (9) doctors looked at oral stage dysphagia (swallowing difficulties that begin in the mouth) with potential effects on function and patient well-being.

To examine the effects of function in TMJ patients, the doctors looked at 178 TMJ/TMD temporomandibular joint dysfunction patients.

There is no doubt that TMJ patients suffer from swallowing difficulties, but do they have cervical instability as well and is this making swallowing more challenging?

In many patients, we see with primary problems related to neck pain and cervical instability we see problems of TMJ. In many patients that we see with problems of TMJ, we see cervical neck pain. Surprisingly, despite the research suggesting the connection, many patients were not made aware that their jaw pain could be a problem originating in the neck.

In the medical journal Clinical Oral Investigations, (10) oral surgeons in Belgium made a connection.

They conducted a study looking for possible correlations between clinical signs of temporomandibular disorders (TMD) and cervical spine disorders.

There is a problem with the chewing muscles contributing to problems in your cervical spine and your entire posture

Swallowing difficulties are hard to manage because in some patient cases, possible yours, you have to continuously “peel the onion,” to get to the true root cause of the patient’s problem. Swallowing difficulties may not be a primary complaint of a patient, but one of the many complaints that seemingly have no answer. Here we are examining whether the muscles of the jaw are negatively impacting your cervical spine and if your swallowing difficulties, indeed many problems you are suffering from, may be from this connection.

In the European Journal of Orthodontics, (11) doctors in Japan made a connection:

What? The TMJ altered your posture by stressing your cervical spine? Isn’t posture a problem of swallowing difficulties? Isn’t posture a problem of everything?

Surgery for swallowing difficulties – high risk – low reward?

When you look at the research above, especially when the bulk of it comes from oral and neurosurgeons, it is not difficult to see that surgery for swallowing difficulties is a high risk – low reward procedure. Let’s be clear though, there are times when surgery is necessary, especially if there is an anatomical deformity that is possibly life-threatening.

Now, what about the bone spurs?

Using exercise to help swallowing difficulties in cervical instability patients is clearly superior to surgery for patients desiring to avoid surgery. The problems of surgical correction of swallowing difficulties from bony overgrowth (osteophytes or bone spurs) is documented in this research from Turkish surgeons from the Gulhane Military Medical Academy and Gelibolu Military Hospital.

This study was presented in The Journal of Craniofacial Surgery (12) and discusses the advantages and disadvantages of anterior cervical osteophytes surgical procedures. (A frontal incision into the throat area or the mouth to get at the cervical bone spurs).

The doctors looked at the operative records of anterior cervical osteophytes patients who did not benefit from conventional treatments and underwent osteophytectomy (bone spur removal).

Five patients were operated with the transcervical anterolateral method (incision into the neck), and 3 patients were operated with the transoral procedure (through the mouth). Those using the transcervical method were likely to encounter complications. Although the transoral procedure is much safer, the patients may face postoperative pain, long healing time, and morbidities as hematoma, cervical instability, and infection after surgery.

While both surgeries can improve swallowing difficulties, the price of complications and further instability in the future was warned about. The researchers did suggest that Transoral approach is not recommended due to slow healing times and postoperative pain, although it creates easier access to the spine.

Does surgery cause swallowing difficulties?

In March 2019 in the journal Clinical Neurology and Neurosurgery, (13) researchers at the David Geffen School of Medicine and the Department of Neurosurgery at Kaiser Permanente discussed the reported incidence of dysphagia after Anterior Cervical Discectomy and Fusion. The researchers commented that up to 79% (4 out of 5 surgical patients) will suffer from swallowing difficulties.

Please see our article Anterior Cervical Discectomy and Fusion – The evidence. Here we discuss the evidence that this surgery can cause more cervical spine instability and deformity

Returning to this study from March 2019, the researchers looked into what caused these problems of swallowing difficulties and further why it appears that doctors are not investigating this problem. The researchers noted:  “There, however, have been no studies that have specifically looked at developing criteria for reducing the incidence of dysphagia for outpatient ACDFs.”

What caused the swallowing difficulties? The researchers found ONLY ONE THING:

Treating Cervical Spine Instability is treating swallowing difficulties

In this video, DMX imaging displays Prolotherapy results in before and after treatment images. This patient’s treatment had problems of a pinched nerve in the cervical spine resolved. Prolotherapy is discussed below. Prolotherapy is a regenerative medicine injection treatment that utilizes dextrose, a simple sugar as a proliferant to rebuild soft tissue structures.

This video demonstrates the alleviation of cervical disc herniation and the patient’s related symptoms.


We will see many patients who were told about surgeries

We will see many patients who were told about surgeries, such as those spoke above and offered surgical consultation for his/her problem with swallowing if there is a concern the problem is due to a diverticulum or outpouching of the throat. However, the surgical recommendation is often compromised by the difficulty in diagnosis.

Conservative treatments may be offered to see if the surgery is warranted or, better yet, avoided.

Recommendations to relieve the symptoms may include a bland diet, eliminating caffeine or alcohol from the diet, modifying the consistency of foods to make them easier to swallow, elevating the head while sleeping, or therapy to strengthen the swallowing muscles, particularly when the swallowing difficulty seems to be the result of neurological disorder. In certain situations drugs that slow the production of stomach acid, muscle relaxants or antacids may be prescribed.

However, the truth is, a person suffering from this often painful and debilitating condition may be seen by numerous specialists and yet find no resolution for the symptoms and, thus, no understanding as to why the condition exists at all.

In our office, we perform a physical examination and use our ultrasound and Digital Motion X-ray machine, described in the video above to get at the cause of the problem rather than to simply seek to treat the symptoms. This helps us determine, if, as often, we are looking at a dysfunction of the autonomic nervous system, a problem of posture, a problem of degenerative aging, a problem possibly of TMJ related challenges.

Swallowing difficulties as well as a host of other symptoms including neck, eye, and facial pain, cervical vertigo, dizziness and ringing in the ears, is very treatable using Prolotherapy to the neck ligaments.

Prolotherapy is, in our opinion, the safest and most effective non-surgical treatment for repairing ligament damage. It stimulates the body to repair the damaged and weakened areas by inducing a mild inflammatory reaction. Since the body heals by inflammation, Prolotherapy stimulates healing.

As mentioned earlier, swallowing difficulty may also be due to an autonomic nervous system dysfunction. While the actual cause of this dysfunction may be elusive, Neural Therapy to the head and neck area has been known to help with swallowing difficulties. Neural therapy involves the injections of anesthetics to help the nerves reset themselves. For example, if the patient had previously had surgery in the mouth or neck area, the scars would be injected as they can act as “interference fields” to the autonomic nervous system.

Brain fog, breathing and swallowing difficulty, dizziness, tinnitus

Brad’s story will resonate with many of you. He will describe the same symptoms and combination of symptoms that many of our patients suffer with when they first see us.

Brad’s story is unique, it may not be typical of the patients we see. Brad with treated with Prolotherapy injections and neck curve correction techniques. Not everyone will achieve these results as results of treatment will vary.

We specifically want to highlight his case because he has some unusual strange sensations in his ear and breathing difficulties because of his problem with his contracting diaphragm.

Patient symptom list:

Patient had these symptoms for 3 – 4 months. It started with a fall of of a ladder. Symptoms did not develop for months

Because of the nature of his injury and ligament damage in his cervical spine, the patient underwent eight prolotherapy treatment sessions. Here is his description:

Research on cervical instability and Prolotherapy

Caring Medical has published dozens of papers on Prolotherapy injections as a treatment in difficult to treat musculoskeletal disorders. We are going to refer to two of these studies as they relate to cervical instability and a myriad of related symptoms including the problems of swallowing difficulties or cervicogenic dysphagia.

In our own research, our Caring Medical research team published a comprehensive review of the problems related to weakened damaged cervical neck ligaments.(14)

This is what we wrote: “To date, there is no consensus on the diagnosis of cervical spine instability or on traditional treatments that relieve chronic neck instability issues like those mentioned above. In such cases, patients often seek out alternative treatments for pain and symptom relief. Prolotherapy is one such treatment that is intended for acute and chronic musculoskeletal injuries, including those causing chronic neck pain related to underlying joint instability and ligament laxity. While these symptom classifications should be obvious signs of a patient in distress, the cause of the problems are not so obvious. Further and unfortunately, there is often no correlation between the hypermobility or subluxation of the vertebrae, clinical signs or symptoms, or neurological signs (such as swallowing difficulties) or symptoms. Sometimes there are no symptoms at all which further broadens the already very wide spectrum of possible diagnoses for cervical instability.”

What we demonstrated in this study is that the cervical neck ligaments are the main stabilizing structures of the cervical facet joints in the cervical spine and have been implicated as a major source of chronic neck pain and in the case of cervicogenic dysphagia type symptoms, cervical instability.

Summary and contact us. Can we help you? How do I know if I’m a good candidate?

We hope you found this article informative and it helped answer many of the questions you may have surrounding Cervical disc disease and difficulty swallowing. Just like you, we want to make sure you are a good fit for our clinic prior to accepting your case. While our mission is to help as many people with chronic pain as we can, sadly, we cannot accept all cases. We have a multi-step process so our team can really get to know you and your case to ensure that it sounds like you are a good fit for the unique testing and treatments that we offer here.

Please visit the Hauser Neck Center Patient Candidate Form

References:

1 Grgić V. Cervicogenic dysphagia: swallowing difficulties caused by functional and organic disorders of the cervical spine. Liječnički vjesnik. 2013 Apr 30;135(3-4):0-. [Google Scholar]
2 Chu EC, Shum JS, Lin AF. Unusual Cause of Dysphagia in a Patient With Cervical Spondylosis. Clinical Medicine Insights: Case Reports. 2019 Dec;12:1179547619882707. [Google Scholar]
3 Verlaan JJ, Boswijk PF, de Ru JA, Dhert WJ, Oner FC. Diffuse idiopathic skeletal hyperostosis of the cervical spine: an underestimated cause of dysphagia and airway obstruction. The Spine Journal. 2011 Nov 1;11(11):1058-67. [Google Scholar]
4 Margelli M, Vanti C, Villafañe JH, Andreotti R. Neck pain and dysphagia associated to disc protrusion and reduced functional stability: A case report. Journal of Bodywork and Movement Therapies. 2017 Apr 1;21(2):322-7. [Google Scholar]
5 Kawamura I, Tominaga H, Tanabe F, Yamamoto T, Taniguchi N. Cervical Alignment of Anterior Cervical Hyperostosis Causing Dysphagia. Spine. 2019 Mar 1;44(5):E269-72. [Google Scholar]
6 Jardine M, Miles A, Allen JE. Swallowing function in advanced age. Current opinion in otolaryngology & head and neck surgery. 2018 Dec 1;26(6):367-74. [Google Scholar]
7 Papadopoulou S, Exarchakos G, Beris A, Ploumis A. Dysphagia associated with cervical spine and postural disorders. Dysphagia. 2013 Dec 1;28(4):469-80. [Google Scholar]
8 Chu EC, Shum JS, Lin AF. Unusual Cause of Dysphagia in a Patient With Cervical Spondylosis. Clinical Medicine Insights: Case Reports. 2019 Dec;12:1179547619882707. [Google Scholar]
9 Gilheaney Ó, Stassen LF, Walshe M. Prevalence, Nature, and Management of Oral Stage Dysphagia in Adults With Temporomandibular Joint Disorders: Findings From an Irish Cohort. Journal of Oral and Maxillofacial Surgery. 2018 Feb 20. [Google Scholar]
10 De Laat A, Meuleman H, Stevens A, Verbeke G. Correlation between cervical spine and temporomandibular disorders. Clinical oral investigations. 1998 Aug 1;2(2):54-7. [Google Scholar]
11 Shimazaki T, Motoyoshi M, Hosoi K, Namura S. The effect of occlusal alteration and masticatory imbalance on the cervical spine. The European Journal of Orthodontics. 2003 Oct 1;25(5):457-63. [Google Scholar]
12 Erdur Ö, Tasli H, Polat B, Sofiyev F, Tosun F, Çolpan B, Birkent H, Öztürk K. Surgical Management of Dysphagia Due to Anterior Cervical Osteophytes. Journal of Craniofacial Surgery. 2017 Jan 1;28(1):e80-4. [Google Scholar]
13 Aguilar DD, Brara HS, Rahman S, Harris J, Prentice HA, Guppy KH. Exclusion Criteria for Dysphagia for Outpatient Single-Level Anterior Cervical Discectomy and Fusion using Inpatient Data from a Spine Registry. Clinical Neurology and Neurosurgery. 2019 Mar 11. [Google Scholar]
14 Steilen D, Hauser R, Woldin B, Sawyer S. Chronic neck pain: making the connection between capsular ligament laxity and cervical instability. The open orthopaedics journal. 2014;8:326. [Google Scholar]

5206

Make an Appointment |

Subscribe to E-Newsletter |

Print Friendly, PDF & Email
Facebook Reviews Facebook Oak Park Office Review
SEARCH
for your symptoms
Prolotherapy, an alternative to surgery
Were you recommended SURGERY?
Get a 2nd opinion now!
WHY TO AVOID:
★ ★ ★ ★ ★We pride ourselves on 5-Star Patient Service!See why patients travel from all
over the world to visit our center.
Current Patients
Become a New Patient

Caring Medical Florida
9738 Commerce Center Ct.
Fort Myers, FL 33908
(239) 308-4701 Phone
(855) 779-1950 Fax Fort Myers, FL Office
We are an out-of-network provider. Treatments discussed on this site may or may not work for your specific condition.
© 2021 | All Rights Reserved | Disclaimer