Abstract：
METHODS: Retrospective Review.
OBJECTIVE: The purpose of this study is to evaluate the efficacy of postoperative cervical orthoses to prevent fixation failure and loss of reduction after operative treatment of cervical spine fractures.
BACKGROUND: While cervical orthoses are most times tolerated in trauma patients, it is not clear that postoperative bracing is effective at reducing the rate of fixation failure or nonunion in this patient population. Cervical collars may delay rehabilitation, increase the risk of dysphagia and aspiration, and can contribute to skin breakdown.
METHODS: All patients who underwent operative stabilization for cervical spine injuries at a single institution between January 2015 and August 2019 were identified through the institutional Research Electronic Data Capture (REDcap) database. Patient data, including cervical spine injury, surgery, post-operative orthosis use, and secondary surgeries for loss of reduction or infection, were recorded for all patients meeting the inclusion criteria. The primary outcome was the loss of reduction or failure of fixation, requiring revision surgery. Statistical analysis was performed using Jamovi (Version 1.1) statistical software.
RESULTS: In all, 201 patients meeting inclusion and exclusion criteria were identified within the study period. Overall, 133 (66.2%) patients were treated with a cervical orthosis postoperatively and 68 (33.8%) patients were allowed to mobilize as tolerated without a cervical orthosis. Fixation failure and loss of reduction occurred in 4 (1.99%) patients. Of these 4, three patients were treated with a cervical orthosis postoperatively. There was no significant difference in the risk of instrumentation failure between patients in the postoperative orthosis and no orthosis groups ( P =0.706).
CONCLUSIONS: The use of cervical orthoses after operative stabilization of cervical spine injuries remains controversial. There was no statistically significant difference in hardware failure or loss of fixation between patients treated in cervical orthoses postoperatively and those who were not.
OBJECTIVE: The purpose of this study is to evaluate the efficacy of postoperative cervical orthoses to prevent fixation failure and loss of reduction after operative treatment of cervical spine fractures.
BACKGROUND: While cervical orthoses are most times tolerated in trauma patients, it is not clear that postoperative bracing is effective at reducing the rate of fixation failure or nonunion in this patient population. Cervical collars may delay rehabilitation, increase the risk of dysphagia and aspiration, and can contribute to skin breakdown.
METHODS: All patients who underwent operative stabilization for cervical spine injuries at a single institution between January 2015 and August 2019 were identified through the institutional Research Electronic Data Capture (REDcap) database. Patient data, including cervical spine injury, surgery, post-operative orthosis use, and secondary surgeries for loss of reduction or infection, were recorded for all patients meeting the inclusion criteria. The primary outcome was the loss of reduction or failure of fixation, requiring revision surgery. Statistical analysis was performed using Jamovi (Version 1.1) statistical software.
RESULTS: In all, 201 patients meeting inclusion and exclusion criteria were identified within the study period. Overall, 133 (66.2%) patients were treated with a cervical orthosis postoperatively and 68 (33.8%) patients were allowed to mobilize as tolerated without a cervical orthosis. Fixation failure and loss of reduction occurred in 4 (1.99%) patients. Of these 4, three patients were treated with a cervical orthosis postoperatively. There was no significant difference in the risk of instrumentation failure between patients in the postoperative orthosis and no orthosis groups ( P =0.706).
CONCLUSIONS: The use of cervical orthoses after operative stabilization of cervical spine injuries remains controversial. There was no statistically significant difference in hardware failure or loss of fixation between patients treated in cervical orthoses postoperatively and those who were not.
摘要：
方法：回顾性回顾。
目的：本研究的目的是评估颈椎骨折手术治疗后颈椎矫形器预防内固定失败和复位丢失的疗效。
背景：虽然颈椎矫形器在创伤患者中大多数情况下是可以耐受的，目前尚不清楚,在该患者人群中,术后支具对降低固定失败或不愈合的发生率是否有效.颈项圈可能会延迟康复，增加吞咽困难和误吸的风险，并可能导致皮肤破裂。
方法：通过机构研究电子数据捕获（REDcap）数据库确定2015年1月至2019年8月期间在单一机构接受颈椎损伤手术稳定的所有患者。患者数据,包括颈椎损伤,手术,术后矫形器使用，减少或感染的二次手术，记录所有符合纳入标准的患者。主要结果是固定的减少或失败，需要翻修手术.使用Jamovi(1.1版)统计软件进行统计分析。
结果：总而言之，在研究期间确定了201名符合纳入和排除标准的患者。总的来说,133例（66.2％）患者在术后接受了颈椎矫形器治疗，而68例（33.8％）患者在没有颈椎矫形器的情况下被允许耐受动员。4例（1.99%）患者发生固定失败和复位丢失。在这4名患者中，有3名患者在术后接受了颈椎矫形器治疗。术后矫形器组和无矫形器组患者的器械失效风险无显著差异(P=0.706)。
结论：颈椎损伤手术稳定后使用颈椎矫形器仍存在争议。术后接受颈椎矫形器治疗的患者与未接受颈椎矫形器治疗的患者之间的硬件故障或固定丢失没有统计学上的显着差异。
目的：本研究的目的是评估颈椎骨折手术治疗后颈椎矫形器预防内固定失败和复位丢失的疗效。
背景：虽然颈椎矫形器在创伤患者中大多数情况下是可以耐受的，目前尚不清楚,在该患者人群中,术后支具对降低固定失败或不愈合的发生率是否有效.颈项圈可能会延迟康复，增加吞咽困难和误吸的风险，并可能导致皮肤破裂。
方法：通过机构研究电子数据捕获（REDcap）数据库确定2015年1月至2019年8月期间在单一机构接受颈椎损伤手术稳定的所有患者。患者数据,包括颈椎损伤,手术,术后矫形器使用，减少或感染的二次手术，记录所有符合纳入标准的患者。主要结果是固定的减少或失败，需要翻修手术.使用Jamovi(1.1版)统计软件进行统计分析。
结果：总而言之，在研究期间确定了201名符合纳入和排除标准的患者。总的来说,133例（66.2％）患者在术后接受了颈椎矫形器治疗，而68例（33.8％）患者在没有颈椎矫形器的情况下被允许耐受动员。4例（1.99%）患者发生固定失败和复位丢失。在这4名患者中，有3名患者在术后接受了颈椎矫形器治疗。术后矫形器组和无矫形器组患者的器械失效风险无显著差异(P=0.706)。
结论：颈椎损伤手术稳定后使用颈椎矫形器仍存在争议。术后接受颈椎矫形器治疗的患者与未接受颈椎矫形器治疗的患者之间的硬件故障或固定丢失没有统计学上的显着差异。
