• World Neurosurg · Nov 2022

    Soft Cervical Orthosis Use Does Not Improve Fusion Rates after 1- and 2-Level Anterior Cervical Discectomy and Fusion.

    • Mark J Lambrechts, Tariq Z Issa, Gregory R Toci, Nicholas D D'Antonio, Brian A Karamian, Eric Tecce, Sebastian Fras, Ian David Kaye, Barrett I Woods, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder, Alan S Hilibrand, and Jose A Canseco.
    • Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Electronic address: mark.lambrechts@rothmanortho.com.
    • World Neurosurg. 2022 Nov 1; 167: e1461e1467e1461-e1467.

    ObjectiveTo determine if postoperative soft cervical orthosis use affects arthrodesis rates on a per-level or construct basis after 1-level and 2-level anterior cervical discectomy and fusion (ACDF).MethodsElectronic medical records were queried for 1-level and 2-level primary ACDF between 2016 and 2019 at a single academic center. Surgeons prescribed either a soft cervical orthosis or no orthosis. Pseudarthrosis rates were evaluated by dynamic cervical spine radiographs with arthrodesis defined by <1 mm of interspinous motion. Continuous and categorical data were compared using analysis of variance or χ2 tests. Multivariate logistic regression analysis was used to examine independent predictors of pseudarthrosis.ResultsA total of 316 unique patients (504 instrumented levels) met the inclusion criteria. Eighty-four percent of patients were prescribed a soft cervical orthosis. Overall, arthrodesis occurred at 344 (80.9%) and 62 (78%) levels in patients with and without cervical orthosis, respectively. When evaluating patients placed in a cervical orthosis versus those who were not, there were no differences in pseudarthrosis or revision rates. Further, there were no differences in pseudarthrosis on a per-level basis. Further, cervical orthosis use was not an independent predictor of pseudarthrosis (odds ratio, 0.86; 95% confidence interval, 0.47-1.57; P =0.623) on multivariate analysis.ConclusionsPostoperative placement of soft cervical orthoses after 1-level or 2-level ACDF was not associated with improved arthrodesis or reduced rate of revision surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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