DYSPHAGIA COMPLICATIONS OF THE MINERVA BRACE

The effects of cervical bracing on swallowing function have not been e valuated in neurologically intact individuals. An 83-year-old woman fe ll, striking her head, and suffered C1, odontoid, and C3 fractures. Sh e had no neurologic deficits and was placed in a Minerva brace. Subseq uently, she developed coughing during her meals, a low-grade fever, an d transient hoarseness, and complained of stiffness in the facial musc les. Aspiration pneumonia in the left lower lobe was diagnosed. In the absence of any neurologic condition, this was attributed to the Miner va brace. Less than 1 week later, the brace was replaced with a halo-v est, and the dysphagia resolved. This case shows that dysphagia and as piration pneumonia may be caused by wearing a cervical brace and illus trates the importance of assessing swallowing in individuals who wear such braces. Particular attention should be paid to swallowing and cer vical bracing in patients with additional risk factors for dysphagia s uch as advanced age or neurologic deficits. (C) 1997 by the American C ongress of Rehabilitation Medicine and the American Academy of Physica l Medicine and Rehabilitation.