Camara Richard, Ajayi Olaide O, Asgarzadie Farbod
Department of Neurosurgery, Loma Linda University Medical Center.
Fontana Medical Center, Kaiser Permanente Southern California.
Cureus. 2016 Jul 14;8(7):e688. doi: 10.7759/cureus.688.
INTRODUCTION & BACKGROUND: The use of external cervical orthosis (ECO) after anterior cervical discectomy and fusion (ACDF) varies from physician to physician due to an absence of clear guidelines. Our purpose is to evaluate and present evidence answering the question, "Does ECO after ACDF improve fusion rates?" through a literature review of current evidence for and against ECO after ACDF.
A PubMed database search was conducted using specific ECO and ACDF related keywords. Our search yielded a total of 1,267 abstracts and seven relevant articles. In summary, one study provided low quality of evidence results supporting the conclusion that external bracing is not associated with improved fusion rates after ACDF. The remaining six studies provide very low quality of evidence results; two studies concluded that external bracing after cervical procedures is not associated with improved fusion rates, one study concluded that external bracing after cervical procedures is associated with improved fusion rates, and the remaining three studies lacked sufficient evidence to draw an association between external bracing after ACDF and improved fusion rates.
We recommend against the routine use of ECO after ACDF due to a lack of improved fusion rates associated with external bracing after surgery.
由于缺乏明确的指导方针，颈椎前路椎间盘切除融合术（ACDF）后外部颈椎矫形器（ECO）的使用在医生之间存在差异。我们的目的是通过对当前支持和反对ACDF后使用ECO的证据进行文献综述，评估并提供证据来回答“ACDF后使用ECO是否能提高融合率？”这一问题。
使用与ECO和ACDF相关的特定关键词在PubMed数据库中进行搜索。我们的搜索共得到1267篇摘要和7篇相关文章。总之，一项研究提供了低质量的证据结果，支持ACDF后外部支撑与提高融合率无关的结论。其余六项研究提供了极低质量的证据结果；两项研究得出颈椎手术后外部支撑与提高融合率无关的结论，一项研究得出颈椎手术后外部支撑与提高融合率有关的结论，其余三项研究缺乏足够证据来证明ACDF后外部支撑与提高融合率之间存在关联。
由于手术后外部支撑未提高融合率，我们建议不常规使用ACDF后的ECO。
