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Meta-Analysis
. 2024 Mar 7;19(1):172.
doi: 10.1186/s13018-024-04661-8.

Comparison of outcomes after anterior cervical discectomy and fusion with and without a cervical collar: a systematic review and meta-analysis

Tingxin Zhang  1 , Gang Gao  1 , Yanhong Li  1 , Feng Gao  1 , Wupeng Yang  1 , Yongjiang Wang  2 , Nana Guo  3
Affiliations
Meta-Analysis

Comparison of outcomes after anterior cervical discectomy and fusion with and without a cervical collar: a systematic review and meta-analysis

Tingxin Zhang et al. J Orthop Surg Res. .

Abstract

Purpose: The clinical outcomes of patients who received a cervical collar after anterior cervical decompression and fusion were evaluated by comparison with those of patients who did not receive a cervical collar.

Methods: All of the comparative studies published in the PubMed, Cochrane Library, Medline, Web of Science, and EMBASE databases as of 1 October 2023 were included. All outcomes were analysed using Review Manager 5.4.

Results: Four studies with a total of 406 patients were included, and three of the studies were randomized controlled trials. Meta-analysis of the short-form 36 results revealed that wearing a cervical collar after anterior cervical decompression and fusion was more beneficial (P < 0.05). However, it is important to note that when considering the Neck Disability Index at the final follow-up visit, not wearing a cervical collar was found to be more advantageous. There were no statistically significant differences in postoperative cervical range of motion, fusion rate, or neck disability index at 6 weeks postoperatively (all P > 0.05) between the cervical collar group and the no cervical collar group.

Conclusions: This systematic review and meta-analysis revealed no significant differences in the 6-week postoperative cervical range of motion, fusion rate, or neck disability index between the cervical collar group and the no cervical collar group. However, compared to patients who did not wear a cervical collar, patients who did wear a cervical collar had better scores on the short form 36. Interestingly, at the final follow-up visit, the neck disability index scores were better in the no cervical collar group than in the cervical collar group. PROSPERO registration number: CRD42023466583.

Keywords: Anterior cervical decompression and fusion; Cervical collar; Meta-analysis; Systematic review.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
The methodological quality of the randomized controlled trials
Fig. 3
Fig. 3
Meta-analysis of CC group versus N-CC group in NDI at 6 weeks after surgery
Fig. 4
Fig. 4
Meta-analysis of CC group versus N-CC group in NDI at the last follow-up
Fig. 5
Fig. 5
Meta-analysis of CC group versus N-CC group in ROM
Fig. 6
Fig. 6
Meta-analysis of CC group versus N-CC group in SF-36
Fig. 7
Fig. 7
Meta-analysis of CC group versus N-CC group in fusion rate
See this image and copyright information in PMC

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