Utility of Cervical Collars Following Cervical Fusion Surgery. Does It Improve Fusion Rates or Outcomes? A Systematic Review.
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BACKGROUND:The use of postoperative cervical collars following cervical fusions is common practice. Its use has been purported to improve fusion rates and outcomes. There is a paucity in the strength of evidence to support its clinical benefit. Our objective is to critically evaluate the published literature to determine the strength of evidence supporting the use of postoperative cervical collar use following cervical fusions. METHODS:A systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (also known as PRISMA) was performed. An online search using Medline and Cochrane Central Register of Controlled Trials databases was used to query prospective and retrospective clinical trials evaluating cervical fusions with or without postoperative collar. RESULTS:The search identified 894 articles in Medline and 65 articles in the Cochrane database. From these articles, 130 were selected based on procedure and collar use. Only 3 studies directly compared between collar use and no collar use. Our analysis of the mean improvement in neck disability index scores and improvement over time intervals did not show a statistically significant difference between collar versus no collar (P = 0.86). CONCLUSIONS:We found no strong evidence to support the use of cervical collars after 1- and 2-level anterior cervical discectomy and fusion procedures, and no studies comparing collar use and no collar use after posterior cervical fusions. Given the cost and likely impact of collar use on driving and the return to work, our study shows that currently there is no proven benefit to routine use of postoperative cervical collar in patients undergoing 1- and 2-level anterior cervical discectomy and fusion for degenerative cervical pathologies.
Published Version (Please cite this version)10.1016/j.wneu.2018.12.066
Publication InfoKarikari, Isaac; Ghogawala, Zoher; Ropper, Alexander E; Yavin, Daniel; Gabr, Mostafa; Goodwin, C Rory; ... Wang, Marjorie C (2018). Utility of Cervical Collars Following Cervical Fusion Surgery. Does It Improve Fusion Rates or Outcomes? A Systematic Review. World neurosurgery, 124. pp. 423-429. 10.1016/j.wneu.2018.12.066. Retrieved from https://hdl.handle.net/10161/19231.
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Assistant Professor of Neurosurgery
As a Neurosurgeon with fellowship training in Spine Surgery, I have dedicated my professional life to treating patients with spine disorders. These include spinal stenosis, spondylolisthesis, scoliosis, herniated discs and spine tumors. I incorporate minimally-invasive spine (MIS) techniques whenever appropriate to minimize pain and length of stay, yet not compromise on achieving the goals of surgery, which is ultimately to get you back to the quality of life you once enjoyed. I was drawn to med
Research Associate, Senior
Dr. Gabr's research has specifically focused on the following broad areas: (i) animal model of myelopathy, (ii) participating in clinical trials in spine field.In the last few years, this research agenda has expanded to include collaborative projects and publications. Dr. Gabr and his colleagues explore benefit of cervical collar following spine fusion, spinal cord injury model, and transforaminal lumbar interbody fusion.Dr. Gabr is the author of "Interleukin-17 synergizes with IFNI&
Assistant Professor of Neurosurgery
Associate Professor of Neurosurgery
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