The Value of Rigid Cervical Orthesis After Fixation and Fusion of Degenerative Cervical Spine in Geriatric Patients

Author(s): J. Dittmer, L. Khalafov, T. Lampmann1, H. Asoglu, M. Janijc, Z. Kiseleva, H. Alenezi, M. Hamed1, H. Vatter, M. Banat

Introduction:

The use of a cervical orthosis after fixation and fusion of the cervical spine in geriatric patients is still controversial. The aim of this study was to find out whether cervical orthosis had an influence on early postoperative clinical-neurological and radiological outcomes.

Methods:

We included and analyzed the data of all geriatric patients who were surgically treated at our spine center for symptomatic degenerative cervical spine disease requiring ventral and/or dorsal fixation with fusion. From 2010 to 2012, the patients received a rigid cervical orthosis postoperatively (group 1); from 2012 to 2014, no orthosis was applied (group 2). All patients were evaluated 3 months after surgery as part of their clinical follow-up. Radiographic and clinical scores were recorded before and after the operation. Postoperative complications within 30 days of the initial surgery were analyzed.

Results:

A total of 84 patients were included, of which 65.5% received postoperative cervical orthosis. Patients with orthosis were significantly younger (p=0.009) and had lower ASA scores (p=0.007) than those in group 2. The clinical and radiologic parameters were similar in both groups but without statistical significance, especially with regard to numeric rating scale (NRS) and neck disability index (NDI) scores. However, it was relevant that the patients with an orthosis did not tolerate it well and developed complications (p <0.001).

Conclusions:

Postoperative cervical orthosis did not lead to improved early clinical and radiological outcomes but were associated with devicerelated complications.