PDF(Pubmed)
Abstract：
Although anterior cervical discectomy and fusion (ACDF) is one of the most frequently performed spinal surgeries, there is no consensus regarding the necessity of prescribing a cervical brace after surgery. This study aimed to investigate any difference in radiological and clinical outcomes when wearing or not wearing cervical braces after single- or double-level ACDF. We examined 2 cohorts of patients who underwent single- or double-level ACDF surgery with and without a cervical brace: patients who underwent ACDF between March 2018 and December 2019 received a cervical brace, while patients who underwent ACDF between January 2020 and May 2021 did not. Each patient was evaluated radiologically and functionally using plain X-ray, modified Japanese Orthopedic Association score, and visual analog scale for neck and arm until 12 months after surgery. Fusion rate, subsidence, and postoperative complications were also evaluated. Eighty-three patients were included in the analysis: 38 were braced and 45 were not. The demographic characteristics and baseline outcome measures of both groups were similar. There was no statistically significant difference in any of the clinical measures at baseline. The modified Japanese Orthopedic Association score and visual analog scale for neck and arm were similar in both groups at all time intervals and showed statistically significant improvement when compared with preoperative scores. In addition, fusion rate, subsidence, and postoperative complications were similar in both groups. Our results suggest that the use of cervical braces does not improve the clinical outcomes of individuals undergoing single- or double-level ACDF.
摘要：
尽管颈椎前路椎间盘切除术和融合术（ACDF）是最常见的脊柱手术之一，对于手术后是否需要处方颈椎支具,目前尚无共识.这项研究旨在调查在单层或双层ACDF后佩戴或不佩戴宫颈支具时的放射学和临床结果的任何差异。我们检查了2组接受单层或双层ACDF手术的患者，有和没有颈椎支架：在2018年3月至2019年12月期间接受ACDF的患者接受了颈椎支架，而在2020年1月至2021年5月期间接受ACDF的患者没有接受ACDF。每位患者均使用X线平片进行放射学和功能评估，修改后的日本骨科协会评分，颈部和手臂的视觉模拟量表，直到手术后12个月。融合率,沉降,术后并发症也进行了评估.83例患者被纳入分析：38例被支撑，45例未被支撑。两组的人口统计学特征和基线结局指标相似。基线时的任何临床测量均无统计学意义的差异。在所有时间间隔，两组的改良日本骨科协会评分和颈部和手臂视觉模拟量表均相似，与术前评分相比，具有统计学上的显着改善。此外,融合率,沉降,两组术后并发症相似。我们的结果表明，使用宫颈支架并不能改善接受单或双水平ACDF的患者的临床结局。
