The longus colli is the primary prevertebral muscle of the anterior cervical spine, lying directly on the anterior vertebral bodies from the upper thoracic spine to the atlas. Along with the longus capitis, scalenes, and deep cervical flexors, it maintains the cervical lordosis from the anterior column and provides the intersegmental stability that the posterior muscles control from behind. It is the prevertebral muscle divided during the anterior cervical spine surgical approach.
| Origin | Anterior bodies and transverse processes of C3 through T3 |
|---|---|
| Insertion | Anterior atlas tubercle and anterior bodies and transverse processes of C2 through C4 |
| Nerve Supply | Ventral rami of C2 through C6 |
| Blood Supply | Ascending cervical artery |
| Actions | Flexion of the cervical spine; Stabilisation of the cervical lordosis; Ipsilateral rotation of the cervical spine (oblique fibres) |
|---|
As the deepest cervical flexor that spans the most vertebral levels, it provides tonic anterior spinal stability that prevents excessive lordosis extension and distributes loads across the cervical segments during flexion movements.
Longus colli calcification (calcific tendinitis or retropharyngeal calcific tendinitis) produces acute severe neck pain, dysphagia, and restricted neck movement with a characteristic retropharyngeal prevertebral soft tissue swelling on CT from the inflammatory response to calcium hydroxyapatite crystal deposition. It resolves spontaneously but can be dramatic in presentation. The longus colli is the key surgical landmark in the anterior cervical approach, requiring its careful retraction to access the vertebral bodies and discs.
The longus colli is not accessible to external palpation due to its deep prevertebral position. It is assessed functionally through deep cervical flexor activation testing.
Calcium crystal deposition producing acute severe neck pain, dysphagia, and prevertebral soft tissue swelling on CT, resolving spontaneously within 1 to 3 weeks with anti-inflammatory treatment.
