The effect of cervical collar external fixation after posterior cervical double-door laminoplasty:A prospective randomized controlled trial
Objective:To investigate the effect of cervical collar external fixation on clinical outcomes after posterior cervical double-door laminoplasty,and to provide evidence-based guidance for accelerated rehabilitation in spine surgery.Methods:A total of 100 patients who underwent posterior cervical double-door laminoplasty in the Department of Spine Surgery,Beijing Jishuitan Hospital from January 2022 to July 2023 were included.Using the random number table method,the participants were divided into the non-collar group(50 patients)and the collar group(50 patients).The patients in the non-collar group did not wear a neck collar postoperatively,while patients in the collar group wore a collar for 2 weeks postoperatively during daily activities.Postoperative axial symptoms,visual analogue scale(VAS)scores of cervical pain,Neck Disability Index(NDI),Japanese cervical Japanese Orthopedics Association(JOA)scores,cervical range of motion(ROM)scores,cervical curvature,and complications were evaluated before and after surgery at 3 months and 6 months in the two groups.Results:There was no significant difference in the incidence of axial symptoms between the two groups at 3 and 6 months postoperatively(all P>0.05).Statistically significant improvements were observed over time for the cervical VAS score,JOA score,NDI,cervical ROM,and cervical curvature(all P<0.001).At 3 months and 6 months postoperatively,both groups showed reduced cervical VAS and NDI,increased JOA scores,and decreased ROM and cervical curvature compared to preoperative values(all P<0.001).There was no significant difference in the cervical VAS score,JOA score,NDI,cervical ROM,or cervical curvature between the two groups(all P>0.05).There was no significant difference in the JOA improvement rate between the two groups at 3 months and 6 months postoperatively(F=1.008,P=0.271;F=4.091,P=0.484).Conclusions:Clinical outcomes of wearing a cervical collar after posterior cervical double-door laminoplasty were similar to those of not wearing a cervical collar.Routine use of a cervical collar after surgery does not increase the incidence of axial symptoms in patients,and has no significant effect on patients'VAS score,JOA score,NDI,cervical ROM,cervical curvature,or complications.
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