Clinical Study Of Anterior Longitudinal Ligament-long Muscle Of Neck Composite Reconstruction Effect On Swallowing Function After Anterior Cervical Decompression And Fusion

Objective To observe the effects of musculus longus colli and anterior longitudinal ligament of early swallowing function in patients after reconstruction of the anterior cervical fusion, and to explore the influencing factors of swallowing function.Methods From october 2012 and october 2014,316 case of patients who suffer from single segment or double segment cervical spondylosis and receive anterior cervical fusion were retrospectively analyzed. And 241 patients who were able to get a complete follow-up were divided into single segmental suture(A1), double segmental suture group(A2), single segmental unstitched (B1) and double segmental unstitched group(B2). The changes of incidence of dysphagia, Swallowing the quality of life (SWAL-QOL) score and the average thickness of prevertebral soft tissue in groups were compared in 2days,1 weeks, 1months,3 months and 6 months follow-up.Results The dysphagia rate was significantly lower in A1、A2 two groups at 2 days、 1 weeks and 1 months postoperatively than that of groups B1、B2(p<0.05). And the incidence rate of dysphagia in A1、B1 two groups was also significantly lower than that of A2、B2 two groups at 2 days、1weeks and 1 months postoperatively (p<0.05). The SWAL-QOL score of A1、A2 two groups was significantly higher than that of B1、B2 two groups at 2 days、lweeks and 1 months postoperatively (p<0.05). And the SWAL-QOL score of A1、B1 two groups at 2 days、1 weeks and 1 months postoperatively was also significantly higher than that of A2、B2 two groups (p<0.05). There were no significant difference between groups with the incidence of dysphagia and SWAL-QOL score in each group at 3 months and 6 months follow-up (p>0.05) And each group of patients with prevertebral soft tissue thickness in operation before and after was not statistical difference (p>0.05).Conclusion The reconstruction of musculus longus colli and anterior longitudinal ligament in anterior cervical fusion and internal fixation can effectively reduce the incidence of postoperative early dysphagia, and adjacent two-level operation cervical spondyloticmyelopathy (CSM) patients were significantly higher than single segmental patients.