|Dr. John Peloza|
It depends on what type of surgery is done and what your individual physician feels is necessary. In general, cervical instrumentation is very rigid in fixing the spine. Most surgeons would add a collar just to protect the fusion site, even with metal, for the early period after the surgery. These collars are generally a combination of a soft inner lining and a more stiff plastic outer shell. They are not rigid fixation; they just help support the neck to decrease the forces on the graft site and metal. If no metal is used during the fusion, then you would absolutely have to use an external collar or brace. If the surgery just involves a soft tissue operation in the cervical spine, such as a posterior discectomy/foraminotomy, then you would probably have a soft collar for symptomatic support for only the first several days after the surgery. This collar offers no real immobilization of the spine; it simply rests the posterior musculature so that the patient is more comfortable after the retraction of the posterior musculature.
|Dr. Joseph Alexander|
The use of collars after surgery remains somewhat controversial, and varies from surgeon to surgeon. Many surgeons who utilize a plate during a cervical fusion operation in a patient without other risk factors are no longer requiring their patients to wear collars at all, or only for a short time. On the other hand, patients who do not have plates, have complex or extensive operations, or have risk factors such as osteoporosis or smoking are often required to wear collars, usually for twelve weeks.
|Dr. Leon J. Grobler|
Sun City, AZ
You may or may not need to wear a collar after neck surgery, depending on your particular situation and your surgeon’s preference. As surgeons continue to move toward using more rigid fixation (spinal implants), the use of bracing is decreasing and in the future may even become obsolete in most cases. Nowadays, even when braces are used, it’s usually for a much shorter period of time. You need to discuss whether you will need any external support with your spinal surgeon.
|Dr. Sean Salehi|
For a one or two level fusion, there is no need for a collar.
|Dr. B. Theo Mellion|
It will depend upon the surgeon who does the operation, whether or not a plate is used, and the type of bone used. Some surgeons will use collars up to 6 weeks, while other surgeons will use collars for a few weeks. For a one-level anterior approach with a plate, a collar is rarely necessary.
|Dr. Daniel Resnick|
The risks of surgery include first of all the risk of any type of surgery which is: bleeding, infection, and the risk of general anesthesia. Anterior approaches to the spine entail dissection through the anterior neck which involves structures such as the trachea, the esophagus, or the carotid arteries. Any of these structures could potentially be injured by the surgical approach. As well as removing the disc we are working right next to the spinal cord and nerve roots and these structures could be injured as well causing worsened problems with weakness or numbness in the arms, legs, as well as potential as bowel, bladder, or sexual dysfunction. In addition, the vertebral artery is close by and can also be injured during the discectomy and this could result in a life threatening stroke. The chance of a serious complication from a cervical discectomy is extremely low and most serious reported complication rates are in the 1-3% range.
|Dr. Douglas Slaughter|
This is a surgeon-dependent answer. For most surgeries done on the neck, a collar does not have to be worn.
|Dr. Jeffrey C. Wang|
Los Angeles, CA
Typically patients wear a collar for a short period of time which helps with pain control, healing of the surgery, and also provides support.
|Dr. Moe R. Lim|
Chapel Hill, NC
This depends on your surgeon’s preferences. For most of my patients, I prescribe a soft or hard collar for a period time after surgery.
|Dr. Brian Subach|
The need for a collar after surgery depends upon the extent of surgery and the specific risks of the patient. Bigger surgeries are more likely to need a brace afterward. Risks include smoking, prior surgery, and osteoporosis.
|Dr. Sebastian Lattuga|
Rockville Centre, NY
The wearing of a cervical collar is a personal decision made by the surgeon. Factors contributing to collar usage include number of levels fused, vertebrectomy verses discectomy, age of the patient, and quality of the patient's bone. Other factors include the patient's physical health, i.e., diabetes, smoking, and obesity. I believe the titanium plate eliminates the need for the collar in most cases.
|Dr. Theodore A. Belanger|
Every surgeon is different on this issue. I generally prescribe the use a collar for up to 6 weeks after surgery, depending on the situation. I feel this maximizes the chance for successful fusion and minimizes the risk of implant failure.
|Dr. Robert S. Pashman|
Los Angeles, CA
In the majority of cases, a cervical collar is not necessary.
|Dr. Allan Levi|
Some patients do require a collar after surgery. The decision of whether to wear a collar and how long it should be worn, needs to be made between the patient and the surgeon in a collaborative way.
|Dr. Rick Sasso|
Most of the time, if an anterior cervical plate is used, spine surgeons do not recommend or don't have to have their patients wear a cervical collar after surgery. If instrumentation is not used, then commonly a cervical collar is worn for six weeks or so.
|Dr. Dennis G. Crandall|
We use a soft collar in some cases to help control the neck and take stress off the neck muscles after surgery. Some patients feel better wearing a collar. After 4 – 8 weeks, the collar is no longer required.
|Dr. Timothy C. Ryken|
Iowa City, IA
Most likely. This is up to the surgeon and is quite variable.
|Dr. Jeffrey Goldstein|
New York, NY
Depending upon the surgeon who does the operation and whether or not a plate is used and the type of bone used. Some surgeons will use collars for up to 6-8 weeks. Other surgeons will use only a soft collar for a week or two for a one-level anterior approach with a plate for comfort only.
|Dr. David S. Baskin|
If your doctor uses a plate, the likelihood is less, and also it is less likely that you will have to wear it for a long period of time. Some doctors feel that it is still best to wear a collar even if a plate is placed, to limit extreme movements. Ask your doctor about this.
|Dr. Brett Taylor|
St. Louis, MO
What we’ve found in our practice is that the use of a metal plate and screws frequently obviates the need for a postoperative collar. Patients undergoing disc replacement surgery also do not require a postoperative cervical collar. In circumstances when multiple areas of the spine are fused and/or in patients with other risk factors that could affect bone fusion or healing, such as nicotine abuse and/or certain health issues such as diabetes and/or systemic rheumatologic disease, an extended period with immobilization such as a collar is necessary. Overall, the use of a brace is determined by the surgeon and the type of surgery performed.
|Dr. Kambiz Hannani|
Los Angeles, CA
The choice of whether to use a cervical collar or not rests with your surgeon. Most surgeons use a collar for about 6 to 10 weeks depending on the number of vertebrae or levels of the spine that are fused.
|Dr. Mark Testaiuti|
This varies with the surgeon. A collar does not replace "sound surgery." Usually in my practice a collar "reminds" a patient they have had surgery. After about two weeks it can be removed for sleeping and walking about in the house and weaned completely in six weeks.
|Dr. W. Christopher Urban|
Glen Burnie, MD
Brace prescription after cervical surgery varies depending on the type of operation performed and surgeon preference. Typically, for patients whose planned course of treatment only involves decompression, I recommend a soft collar for comfort, which may be removed at the patient’s discretion. However, after any fusion procedure, I recommend that a collar be worn for at least six weeks to give the bone the best chance to heal.
|Dr. Randy Davis|
Glen Burnie, MD
The use of a brace is again the surgeon's preference. There is no one good study that says the use of a brace significantly affects the ability of fusions to heal. I personally still use a cervical collar for a period of six weeks following most neck fusions and am interested in doing studies to decide if this immobilization is even necessary or beneficial for the patient.
|Dr. Paul Saiz|
With the advancements in technology and hardware as well as bone graft substitutes, it is surgeon dependent whether patients will need to wear a collar.
|Dr. Kevin Yoo|
Nowadays, collars are rarely worn after surgery because of the widespread use of spinal implants, called cervical plates. Collars are still worn when a plate is not implanted or when the surgery involves a multi-level fusion.
|Dr. Mark R. McLaughlin|
That depends on the surgeon's preference. If a plate has been used, then usually a collar is not needed.
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.