PT  - JOURNAL ARTICLE
AU  - CAPLAN, IAN F.
AU  - SINHA, SAURABH
AU  - OSIEMO, BENJAMIN
AU  - MCCLINTOCK, SCOTT D.
AU  - SCHUSTER, JAMES M.
AU  - SMITH, HARVEY
AU  - GLAUSER, GREGORY
AU  - SHARMA, NIKHIL
AU  - OZTURK, ALI K.
AU  - ALI, ZARINA S.
AU  - MALHOTRA, NEIL R.
TI  - The Utility of Cervical Spine Bracing As a Postoperative Adjunct to Multilevel Anterior Cervical Spine Surgery
AID  - 10.14444/7022
DP  - 2020 Apr 01
TA  - International Journal of Spine Surgery
PG  - 151--157
VI  - 14
IP  - 2
4099  - https://www.ijssurgery.com/content/14/2/151.short
4100  - https://www.ijssurgery.com/content/14/2/151.full
SO  - Int J Spine Surg2020 Apr 01; 14
AB  - Background: Use of cervical bracing/collar subsequent to anterior cervical spine discectomy and fusion (ACDF) is variable. Outcomes data regarding bracing after ACDF are limited. Here, we study the impact of bracing on short-term outcomes related to safety, quality of care, and direct costs in multilevel ACDF.Methods: Retrospective cohort analyses of all consecutive patients undergoing multilevel ACDF with or without bracing from 2013 to 2017 was undertaken (n = 616). Patient demographics and comorbidities were analyzed. Tests of independence and logistic regressions were used to assess differences in length of stay (LOS), discharge disposition (home, assisted rehabilitation facility [ARF], or skilled nursing facility [SNF]), quality-adjusted life year (QALY), direct cost, readmission within 30 days, and emergency room (ER) visits within 30 days.Results: Amongst the study population, 553 were braced and 63 were not braced. There was no difference in comorbidities (P > .05) such as obesity, smoking, chronic obstructive pulmonary disease, hypertension, coronary artery disease, congestive heart failure, and problem list number. A significant difference in American Society of Anesthesiologists (ASA) score was found, with more ASA 2 patients in the braced cohort and more ASA 3 patients in the unbraced cohort (P = .007). LOS was extended for the unbraced group (median 156.9 ± 211.4 versus 86.67 ± 130.6 h, P = .003), and ER visits within 30 days were 0.21 times less likely in the braced group (P = .006). There was no difference in readmission (P = .181), QALY gain (P = .968), and direct costs (P = .689).Conclusion: Bracing following multilevel cervical fixation does not alter short-term postoperative course or reduce the risk for early adverse outcomes in a significant manner.