PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1814442
Research Article

Rigid Cervical Collars after Posterior Cervical Fusion: Do They Improve Outcomes? A Randomized Clinical Trial

Autor*innen

  • Aylar Havazyari

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Amirhossein Kamroo 

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Sadegh Bagherzadeh 

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    2   Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

  • Mohammadtaha Ranji

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Faramarz Roohollahi

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Abolfazl Paeenmahali

    3   Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Morteza Faghih-Jouibari

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Milad Shafizadeh

    1   Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

  • Diego Soto Rubio 

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Dana Saleh

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Mark Greenberg

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Puya Alikhani

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States

  • Mohsen Rostami 

    4   Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Objective

To evaluate whether the postoperative use of a rigid cervical collar after posterior cervical decompression and fusion (PCDF) improves neck pain, functional disability, and quality of life in patients with degenerative cervical myelopathy (DCM).

Materials and Methods

A single-blind, randomized controlled trial was conducted involving 60 adult patients with magnetic resonance imaging–confirmed DCM undergoing PCDF at two tertiary centers. Participants were randomly assigned to either a rigid cervical collar group (n = 30) or a no-collar group (n = 30) postoperatively. Outcomes were measured at 1, 3, 6, and 12 months postsurgery.

Statistical Analysis

The primary outcome was axial neck pain at 1 month, measured by the visual analog scale (VAS). Secondary outcomes included the neck disability index (NDI) and the 36-Item Short Form Survey (SF-36). Statistical tests included paired t-tests, Mann–Whitney's U tests, and repeated-measures analysis of variance, with all data analysis performed by investigators blinded to group allocation. Post hoc power analysis was conducted to assess statistical sensitivity.

Results

Both groups experienced significant improvements in VAS, NDI, and SF-36 scores over time. However, there were no statistically significant differences between the collar and no-collar groups at any measured time point. At 1 month, mean VAS scores were 4.30 ± 0.75 (collar) and 4.07 ± 0.58 (no collar; p = 0.233). Gains in disability and quality-of-life measures surpassed minimal clinically important differences for both groups, but without significant between-group differences. The trial was underpowered (post hoc power = 26.4%) to detect small-to-moderate differences; therefore, outcomes should be interpreted cautiously.

Conclusion

The use of a rigid cervical collar after PCDF did not confer additional benefit for neck pain, functional outcomes, or quality of life compared with no collar. These findings suggest that routine rigid cervical collar prescription after PCDF should be reconsidered. Given the study's limited statistical power (26.4%) and lack of surgeon/patient blinding, findings should be interpreted cautiously.

Keywords

cervical collar - myelopathy - cervical fusion - neck pain - functional outcome

Authors' Contribution

The conception and design of the study were performed by A.H., M.R., and M.F.J. Administrative support was provided by M.R. A.H., M.R., and F.R. handled study materials and patient recruitment, also contributing to data collection and assembly. Data analysis and interpretation were performed by A.H., S.B., M.S., and A.P. The manuscript was written by A.K., M.T.R., S.B., M.R., D.S.R., and D.S. Critical revision was performed by P.A., M.G., and M.R. All authors gave final approval of the manuscript.


Ethical Approval

We obtained ethical approval for this study from the Shariati Hospital Ethics Committee under protocol code IR.TUMS.SHARIATI.REC.1402.132.




Publikationsverlauf

Artikel online veröffentlicht:
29. Dezember 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India