The Early Effects of Longus Colli Muscle and Anterior Longitudinal Ligament Reconstructions on Swallowing Function after Anterior Cervical Surgery: A Six-Month Follow-Up Study

Background: Anterior cervical discectomy and fusion (ACDF) is the gold standard surgery used to treat cervical degenerative disease. Dysphagia and hoarseness are the two most common complications that occur after anterior cervical surgery (ACS). In this study, we aim to evaluate the early effects of longus colli muscle (LCM) and anterior longitudinal ligament (ALL) reconstructions on swallowing function after ACS. Methods: We recruited 91 patients (35 males and 56 females; mean age: 49.41 +/- 8.60 years [range: 26-72 years]) who have undergone either ACDF or anterior cervical corpectomy and fusion (ACCF) between August 2019 and October 2021. Patients were divided into LCM and ALL suture group (Group A), and LCM and ALL non-suture group (Group B). Assessments of the incidence of dysphagia and the swallowing quality of life (SWAL-QOL) were completed in 2 days, 1 week, 1 month, 3 months and 6 months after surgery. Average prevertebral soft tissue thickness (APSTT) were measured on lateral cervical spine radiographs taken with X-rays 2 days, 1 month, 3 months and 6 months after surgery. Results: In the 2-day, 1-week and 1-month postoperative follow-up, the incidence of dysphagia in group A was significantly lower than that in group B (p < 0.05), and the SWAL-QOL scores of group A were significantly higher than those of group B (p < 0.05). In the 3-month and 6-month postoperative follow-up, no significant differences were found between groups A and B in terms of the incidence of dysphagia (p > 0.05). In the 6-month postoperative follow-up, no significant differences were found between the groups in terms of SWAL-QOL scores (p > 0.05). There were no significant differences in APSTT between groups during postoperative follow-up (p > 0.05). Conclusion: The reconstructions of LCM and ALL in ACS can effectively improve short-term postoperative swallowing function.

Automated summary

The study found that reconstruction of the longus colli muscle and anterior longitudinal ligament can effectively improve swallowing function in the early postoperative period after anterior cervical surgery. The reconstruction group had a significantly lower incidence of dysphagia and higher SWAL-QOL scores compared to the non-reconstruction group at 2 days, 1 week, and 1 month postoperatively. However, there were no significant differences between the groups in terms of dysphagia incidence and SWAL-QOL scores at 3 months and 6 months postoperatively. Additionally, there were no significant differences in average prevertebral soft tissue thickness between the groups during the postoperative follow-up period.