SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Support or constraint? A comprehensive analysis of postoperative cervical bracing practices: insights from the Italian society of neurosurgery (SINch) survey and a systematic review of the literature.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aims to capture current bracing practices for cervical spine surgery among members of the Spine Section of the Italian Society of Neurosurgery (SINch). It explores the rationale behind these practices and compares them with available evidence in the literature. A systematic review was conducted to evaluate whether patients undergoing single- or double-level anterior cervical discectomy and fusion (ACDF) without plating experience better clinical or radiological outcomes with or without postoperative cervical bracing.
methodsAn anonymous 45-item survey was distributed to SINch Spine Section Members to collect data on bracing protocols following various cervical spine procedures, including degenerative and traumatic conditions, and fusion and non-fusion procedures. Additionally, a systematic review adhering to PICO standards and PRISMA guidelines, was performed to evaluate the evidence on bracing after ACDF without plating. Eligible studies included prospective data on the Neck Disability Index (NDI) and fusion rates following single- or multiple-level ACDF without plating for cervical spondylosis. Methodological quality was evaluated using the Jadad Scale for randomized controlled trials and the GRADE framework for overall evidence assessment.
resultsThe survey (61 respondents, 15% response rate) revealed that 85.2% of surgeons prescribed cervical collars for 2-level ACDF without plating. The main reasons cited were pain reduction and early mobilization, often based on personal experience and colleague recommendations, rather than literature evidence (14%). The systematic review identified two prospective studies, both showing no statistically significant impact of bracing on fusion rates. One study reported minor short-term improvements in neck pain (p0.05) with bracing, but no long-term differences in NDI were found.
conclusionsCervical bracing following single- or double-level ACDF without plating remains controversial, with no significant difference in fusion rates, kyphosis progression, or cage migration between braced and non-braced patients. The routine use of postoperative bracing appears driven by tradition rather than strong evidence, suggesting that a more selective and evidence-based approach is warranted. Further high-quality research is needed to establish standardized guidelines.
Indexed as
Identifiers
40447831What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.