AAOS2017: Cervical bracing after ACDF does not improve fusion rate or clinical outcome

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
50 patients undergoing one- or two-level anterior cervical discectomy and fusion (ACDF) were randomized to postoperative management with our without a rigid cervical collar for a period 6 weeks. Neck Disability Index (NDI), subsidence, and fusion outcomes were evaluated over a period of 24 months. There were no Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Non-Industry funded
Sponsor: The Cervical Spine Research Society
Conflicts: None disclosed
Why was this study needed now?
Rigid cervical collars are often used following ACDF procedures to limit cervical motion. While these braces are believed to promote fusion and minimize subsidence, few high-quality trials have actually assessed their ability to minimize these complications and their impact on clinical outcomes.
What was the principal research question?
Does the use of a rigid cervical collar for 6 weeks following ACDF provide advantages compared to no brace use in fusion, subsidence and clinical outcomes?
Population: 50 patients undergoing one- or two-level anterior cervical discectomy and fusion.
Intervention: No Brace Group: Patients did not receive a rigid cervical collar following ACDF. (n=22 completed the study, Mean age: 50)
Comparison: Brace Group: Patients received a rigid cervical collar brace to restrict cervical motion following ACDF for a 6 week period. (n=22 completed the study, Mean age: 55)
Outcomes: Outcomes included Neck Disability Index (NDI) scores, fusion rate assessed using computer tomography scans, and subsidence rates assessed using lateral cervical radiographs.
Methods: RCT
Time: Subsidence was assessed at 6 months, fusion was assessed at 12 months, and NDI was assessed at 24 months.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.