Multimodal quantitative ultrasound assessment of perioperative neck muscle alterations in patients with cervical spondylosis.

Background: Cervical spondylosis (CS) involves degenerative changes that increase muscle fatigue and stiffness. Postoperative cervical collars are commonly used to maintain stability. This study used multimodal ultrasound to compare neck muscle thickness and stiffness between patients with CS and healthy controls (HC), and to longitudinally evaluate muscle parameter changes associated with different postoperative cervical collar wearing durations. Methods: This prospective study enrolled 40 patients undergoing cervical spine surgery and 40 healthy volunteers matched by age, sex, and body mass index (BMI) as HC. The thickness and stiffness of eight neck muscles in the anterior and posterior cervical regions were measured. Subsequently, 18 patients were randomly allocated to two groups for longitudinal follow-up. Group A wore a cervical collar for 1 month, whereas Group B wore one for 3 months. Longitudinal changes in neck muscle parameters were quantitatively measured, and the generalized estimating equation (GEE) model was used to evaluate changes at 3 and 6 months postoperatively. Results: No significant baseline differences were found between the case and HC groups. Regarding posterior cervical muscles, the case group showed significantly greater trapezius thickness in the neutral position (0.18 Conclusions: Multimodal ultrasound effectively detects changes in cervical muscle thickness and stiffness in patients with CS. Longer cervical collar wearing duration may be associated with higher muscle stiffness; however, these findings are preliminary owing to the small sample size, and further large-scale studies are warranted.