{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:40:38Z","timestamp":1769924438598,"version":"3.49.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":1196,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>\n          Background Context: Use of cervical bracing\/collar subsequent to anterior cervical spine discectomy and fusion (ACDF) is variable. Outcomes data regarding bracing after ACDF are limited. Purpose: The purpose of the study is to study the impact of bracing on short-term outcomes related to safety, quality of care, and direct costs in single-level ACDF. Study Design\/Setting: This retrospective cohort analysis of all consecutive patients (n = 578) undergoing single-level ACDF with or without bracing from 2013 to 2017 was undertaken. Methods: Patient demographics and comorbidities were analyzed. Tests of independence (Chi-square, Fisher's exact, and Cochran\u2013Mantel\u2013Haenszel test), Mann\u2013Whitney\u2013Wilcoxon tests, and logistic regressions were used to assess differences in length of stay (LOS), discharge disposition (home, assisted rehabilitation facility-assisted rehabilitation facility, or skilled nursing facility), quality-adjusted life year (QALY), surgical site infection (SSI), direct cost, readmission within 30 days, and emergency room (ER) visits within 30 days. Results: Among the study population, 511 were braced and 67 were not braced. There was no difference in graft type (P = 1.00) or comorbidities (P = 0.06\u20130.73) such as obesity (P = 0.504), smoking (0.103), chronic obstructive pulmonary disease hypertension (P = 0.543), coronary artery disease (P = 0.442), congestive heart failure (P = 0.207), and problem list number (P = 0.661). LOS was extended for the unbraced group (median 34.00 + 112.15 vs. 77.00 + 209.31 h, P &lt; 0.001). There was no difference in readmission (P = 1.000), ER visits (P = 1.000), SSI (P = 1.000), QALY gain (P = 0.437), and direct costs (P = 0.732). Conclusions: Bracing following single-level cervical fixation does not alter short-term postoperative course or reduce the risk for early adverse outcomes in a significant manner. The absence of bracing is associated with increased LOS, but cost analyses show no difference in direct costs between the two treatment approaches. Further evaluation of long-term outcomes and fusion rates will be necessary before definitive recommendations regarding bracing utility following single-level ACDF.<\/jats:p>","DOI":"10.4103\/ajns.ajns_236_18","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T08:39:50Z","timestamp":1550824790000},"page":"461-466","source":"Crossref","is-referenced-by-count":13,"title":["The utility of cervical spine bracing as a postoperative adjunct to single-level anterior cervical spine surgery"],"prefix":"10.1055","volume":"14","author":[{"given":"Ian","family":"Caplan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Piazza","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Department of Neurosurgery and Orthopedic Surgery, Translational Spine Research Laboratory, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Glauser","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Osiemo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia"},{"name":"Department of Mathematics, West Chester Statistical Institute, West Chester University, West Chester, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McClintock","sequence":"additional","affiliation":[{"name":"Department of Mathematics, West Chester Statistical Institute, West Chester University, West Chester, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Department of Neurosurgery and Orthopedic Surgery, Translational Spine Research Laboratory, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,9]]},"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/ajns.AJNS_236_18.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T23:38:21Z","timestamp":1662766701000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.4103\/ajns.AJNS_236_18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,9,9]]},"published-print":{"date-parts":[[2019,6]]}},"URL":"https:\/\/doi.org\/10.4103\/ajns.ajns_236_18","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}