{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:35:53Z","timestamp":1789799753090,"version":"4.0.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>The omohyoid muscle is frequently encountered during anterior cervical spine surgery, particularly at the C5\u2013C7 levels, yet it has received limited emphasis in spinal literature. Its superior belly often crosses the operative corridor, leading surgeons to choose between preservation, retraction, or sectioning. This narrative review synthesizes anatomical and clinical evidence regarding omohyoid variability, surgical handling, and postoperative outcomes in anterior cervical discectomy and fusion procedures. Anatomical studies reveal substantial muscle variation, including accessory slips and aberrant insertions, which can influence exposure. Emerging clinical data suggest that sectioning the superior belly when obstructive improves visualization and may reduce operative time and blood loss without significantly increasing dysphagia, dysphonia, or cosmetic concerns. However, prospective studies with standardized outcome measures remain limited. Understanding this \u201cforgotten anatomy\u201d may enhance operative planning, optimize exposure, and refine technique in lower cervical approaches.<\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_196_25","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T15:02:16Z","timestamp":1768489336000},"page":"8-14","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["The omohyoid muscle in anterior cervical approaches: Forgotten anatomy with surgical and functional implications"],"prefix":"10.4103","volume":"17","author":[{"given":"Hasan Ali","family":"Ayd\u0131n","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Zonguldak B\u00fclent Ecevit University Medical School, Zonguldak, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emrah","family":"Keskin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zonguldak B\u00fclent Ecevit University Medical School, Zonguldak, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Kalayc\u0131","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zonguldak B\u00fclent Ecevit University Medical School, Zonguldak, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"R1-20260420","first-page":"40","article-title":"The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion","author":"Sm\u0131th","year":"1958","journal-title":"J Bone Joint Surg Am"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"602","DOI":"10.3171\/jns.1958.15.6.0602","article-title":"The anterior approach for removal of ruptured cervical disks","volume":"15","author":"Cloward","year":"1958","journal-title":"J Neurosurg"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1590\/S1807-59322008000400018","article-title":"A study of anatomical variability of the omohyoid muscle and its clinical relevance","volume":"63","author":"Rai","year":"2008","journal-title":"Clinics (Sao Paulo)"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1447-073X.2006.00138.x","article-title":"Anatomical study of the human omohyoid muscle: regarding intermediate morphologies between normal and anomalous morphologies of the superior belly","volume":"81","author":"Sukekawa","year":"2006","journal-title":"Anat Sci Int"},{"key":"R8-20260420","first-page":"570","article-title":"The surgical anatomy of the cervical sympathetic trunk during the anterolateral approach to the cervical spine","volume":"7","author":"Civelek","year":"2007","journal-title":"J Neurosurg Spine"},{"key":"R9-20260420","first-page":"1648","article-title":"Medial versus lateral approach for anterior cervical discectomy and fusion: impact on postoperative dysphagia","volume":"41","author":"Fengbin","year":"2013","journal-title":"J Int Med Res"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13018-023-03937-9","article-title":"Upper cervical anterior fusion to C2 with temporary infrahyoid muscle detachment: clinical outcomes","volume":"18","author":"Okamoto","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"7131","DOI":"10.1038\/s41598-021-86502-w","article-title":"Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles","volume":"11","author":"Chang","year":"2021","journal-title":"Sci Rep"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"984","DOI":"10.3349\/ymj.2010.51.6.984","article-title":"Variation of the infrahyoid muscle: duplicated omohyoid and appearance of the levator glandulae thyroideae muscles","volume":"51","author":"Kim","year":"2010","journal-title":"Yonsei Med J"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1002\/ca.20554","article-title":"An unknown anatomical variation of the omohyoid muscle","volume":"20","author":"Kasapoglu","year":"2007","journal-title":"Clin Anat"},{"key":"R15-20260420","doi-asserted-by":"crossref","DOI":"10.5115\/acb.25.118","article-title":"Three-headed duplicated omohyoid muscle in a human cadaver","author":"Cavalcante","year":"2025","journal-title":"Anat Cell Biol"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/s00276-014-1374-7","article-title":"Duplicated posterior belly of the digastric muscle and absence of the omohyoid muscle: a case report and review of the literature","volume":"37","author":"Zhao","year":"2015","journal-title":"Surg Radiol Anat"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1055\/s-0033-1354253","article-title":"Oropharyngeal dysphagia after anterior cervical spine surgery: a review","volume":"3","author":"Anderson","year":"2013","journal-title":"Global Spine J"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1097\/00007632-200211150-00007","article-title":"Incidence of dysphagia after anterior cervical spine surgery","volume":"27","author":"Bazaz","year":"2002","journal-title":"Spine"},{"key":"R19-20260420","first-page":"372","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R20-20260420","first-page":"21","article-title":"Risk factors for dysphagia after anterior cervical spine surgery: a prospective study","volume":"16","author":"Lee","year":"2016","journal-title":"Spine J"},{"key":"R21-20260420","first-page":"250","article-title":"Dysphagia rates in single- and multiple-level anterior cervical discectomy and fusion","volume":"6","author":"Oh","year":"2020","journal-title":"J Spine Surg"},{"key":"R22-20260420","first-page":"36","article-title":"Anterior cervical spine surgery-associated complications in a retrospective case-control study","volume":"156","author":"Tasiou","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"R23-20260420","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1097\/BRS.0b013e318154c57e","article-title":"Anterior cervical discectomy and fusion associated complications","volume":"32","author":"Fountas","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"R24-20260420","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1089\/lap.2015.0194","article-title":"Endoscopic surgery for omohyoid muscle syndrome","volume":"25","author":"Zhu","year":"2015","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R25-20260420","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s40477-022-00754-4","article-title":"Ultrasonographic measurements of the omohyoid muscle during shoulder muscle contraction","volume":"26","author":"Toledano","year":"2023","journal-title":"J Ultrasound"},{"key":"R26-20260420","doi-asserted-by":"crossref","first-page":"841","DOI":"10.3928\/0147-7447-20000801-19","article-title":"Anterior approach to the cervical spine: surgical anatomy","volume":"23","author":"Lu","year":"2000","journal-title":"Orthopedics"},{"key":"R27-20260420","first-page":"271","article-title":"Extreme multi-level anterior cervical discectomy and fusion","volume":"66","author":"Morgan","year":"2013","journal-title":"S D Med"},{"key":"R28-20260420","doi-asserted-by":"crossref","first-page":"367","DOI":"10.14740\/jocmr4551","article-title":"The role of cervical muscle morphology in surgical treatment of degenerative disc disease based on MRI studies","volume":"13","author":"Siasios","year":"2021","journal-title":"J Clin Med Res"},{"key":"R29-20260420","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.jor.2019.06.003","article-title":"Platysma-sparing approach to anterior cervical spine surgery: a less-exposure technique","volume":"16","author":"Chin","year":"2019","journal-title":"J Orthop"},{"key":"R30-20260420","first-page":"S373","article-title":"Dysphagia following anterior cervical spine surgery: a review","volume":"4","author":"Epstein","year":"2013","journal-title":"Surg Neurol Int"},{"key":"R31-20260420","doi-asserted-by":"crossref","first-page":"221","DOI":"10.5115\/acb.19.041","article-title":"Ansa cervicalis: a comprehensive review of its anatomy, variations, pathology, and surgical applications","volume":"52","author":"Kikuta","year":"2019","journal-title":"Anat Cell Biol"},{"key":"R32-20260420","first-page":"233","article-title":"An anatomical study of the arterial and nerve supply of the infrahyoid muscles","volume":"68","author":"Meguid","year":"2009","journal-title":"Folia Morphol"},{"key":"R33-20260420","first-page":"949","article-title":"Onset timing of hyoid muscle activation during cervical flexion: an EMG study","volume":"12","author":"Sageshima","year":"2022","journal-title":"Life (Basel)"},{"key":"R34-20260420","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/01.BRS.0000129100.59913.EA","article-title":"Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures","volume":"29","author":"Smith-Hammond","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"R35-20260420","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1097\/BRS.0b013e31823a7a5b","article-title":"The Dysphagia Short Questionnaire: validation with 12-month follow-up after anterior cervical spine surgery","volume":"37","author":"Skeppholm","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"R36-20260420","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s12178-016-9349-4","article-title":"Cervical radiculopathy","volume":"9","author":"Iyer","year":"2016","journal-title":"Curr Rev Musculoskelet Med"},{"key":"R37-20260420","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2106\/00004623-196042040-00001","article-title":"Stabilization of the cervical spine by anterior fusion","volume":"42-A","author":"Bailey","year":"1960","journal-title":"J Bone Joint Surg Am"},{"key":"R41-20260420","first-page":"793","article-title":"Anterior approach to the cervical spine: elegance lies in its simplicity","volume":"15","author":"Arumalla","year":"2021","journal-title":"Asian Spine J"},{"key":"R42-20260420","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.spinee.2012.03.024","article-title":"Dysphagia and soft-tissue swelling after anterior cervical surgery","volume":"12","author":"Kepler","year":"2012","journal-title":"Spine J"},{"key":"R43-20260420","doi-asserted-by":"crossref","first-page":"239","DOI":"10.5115\/acb.2017.50.3.239","article-title":"Unusual muscle of the anterior neck: cadaveric findings with surgical applications","volume":"50","author":"Iwanaga","year":"2017","journal-title":"Anat Cell Biol"},{"issue":"2","key":"R44-20260420","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00405-020-06507-5","article-title":"European white paper: oropharyngeal dysphagia in head and neck cancer","volume":"278","author":"Baijens","year":"2021","journal-title":"Eur Arch Otorhinolaryngol"}],"updated-by":[{"DOI":"10.4103\/jcvjs.jcvjs_242_26","type":"retraction","label":"Retraction","source":"publisher","updated":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000}}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_196_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:40:51Z","timestamp":1786650051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_196_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_196_25","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}