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Collars after Cervical surgery .... Yes or No

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:23 AM in Neck Pain: Cervical
This keeps coming up and I am sure it is a good topic to discuss. What type of cervical surgery did you have? Were you required to wear a collar and for how long.

Personally, I had ACDF surgery C3>C6 with titanium plates and screws and cadaver bone on Sept 17th and woke up without a collar because my doctor does not believe in using them. He is a NS who specializes in complex spinal surgery. He does believe in bone stimulators and I am using that 4 hours a day. Not having a collar scares me to death because I am so afraid that I will do something to mess up this surgery and I never want to go through it again. I was not given a lot of instruction on what not to do other then no push/pull or lift +5 pounds. Seems like I am turning my neck all the time without thinking about it. Well...my neck itself restricts me since it has limited range but still sure hope I am not hurting anything.



  • since my first ACDF. After my first operation in 1999 the post surgical procedure was a hard collar (Philadelphia collar) for almost 3 months. It was a horror to wear and learn to live with.

    This year I slipped and fell on some ice and had to repeat the same fusion at C5-C6, this time with instrumentation. I awoke to a soft collar, like the ones you buy at CVS. The ortho surgeon told me that the protocol these days is to shy away from hard collars except in cases of extreme trauma and instability. Wit the links and screws in my neck now he said that it's not going to go anywhere and the soft collar was for the car ride home, and when I felt like it needed extra support. I have to say that it was wonderfully liberating.

    Next month I am scheduled for an posterior foraminotomy from C4-C7 and he may have to give me a Philly collar. I am praying not.

    Good luck with your recovery. If you really think you need a hard collar, you can always buy one in a surgical supply center (you might want to think about it for washing your hair, combing etc. as it supports you so much better than a soft collar).

  • LJ, my surgery is scheduled for Oct. 21 and my surgeon has told me that I'll be wearing a hard collar for 4 weeks and a soft collar for the following 4 weeks. Seems extreme to me, but I have to follow his instructions.

    No collar at all would scare me too. :SS Maybe he would allow you a soft collar while you're awake to simply limit your neck movement?
  • I had a posterior lamenectomy with lateral screw fixation, so all in all I have 3 fusions in the front from a previous surgery and now 3 in the back, all the plates and screws and bells and whistles... I was not in a brace for my 1st surgury and returned to a pretty hard job in 4 months, (catering and retail manager at a huge hospital..... 4 years later I just had my last surgery, I was in a hard collar when I got back to my room and will have it on 24/7 for 3 months.... (My last fusion was not solid) He is not taking any chances this time, so I have the stimulator also for 4 hours per day.. I have come to rely on my collar as it helps me to remember to not push it...People always stare at me though when I go out and that become annoying.
    They sometimes even stop me and wonder what happened, I always want to come up with somthing good like I had sex on my head, or something like that... but no I smile and tell them. I have an amazing dr and staff so I am lucky, He calls my house to check on me and I can email the nurses if I need any questions answered,, Im thinking of getting a tatoo on the back of my neck with a shamrock, He is sooooo Irish, anyways, thats my story, sorry for being so long....
  • LJ

    I had a 3 level ACDF c4-7 on 2-12-08 woke up with hard collar on and wore it until my 1st post op visit 10 days later when I was told I did not have to wear it any longer.....kept on following up as supposed to and always told neck looked good....had 2 separate infections in the incision, 1- 1 mo later on right side 2nd 2 mo later on left side. Also had a lumbar decompression on 4-1-08 which did not heal and was infected which was followed by a I and D of the incision. During this time my symptoms came back from my neck, myelopathy, Lhermittes and as always my neck looked great......I finally went to another surgeon who took xrays and at 1 look told me I was not fusing and sent me for MRI....and EMG/NCS......all results were postiive for the myelopathy, lhermittes and showed that not only was I not fusing but I also had new damage above..

    I write this reply 1 week post op from a posterior fusion levels C3-7 with and autograft from my hip. I was immediately put in a soft collar ONLY while in bed and as soon as I sit up I put on my ASPEN hard collar until I go back to bed.I will wear my Aspen collar for 6 weeks and maybe have to go back to the soft collar. I also got a bone stimulator today to help me fuse.
    I learned alot this time around and what I should have done maybe from the start so:

    The moral of the story is......

    :? Choose your surgeon wisely.
    :/ Ask lots of questions even if they sound stupid to you.....no question is stupid, except those that are NOT asked.
    :?? When you find out exactly what the surgeon will do during the surgery and have you do after the surgery READ UP on the procedure compare what he told you to what you read, ask other members who have been through it and if you are still puzzled by anything sit down with the surgeon. I was told I did not have to see my surgeon again prior to surgery but I still had some questions and wanted my husband to meet him prior to surgery so I made another appointment and was welcomed to do so by him and his office. I then had lots of peace of mind about my surgery, knew that the surgeon was always open to questions and available as well as his staff. Four surgeries was a bit much for me in 7 months but having this last one I was much more educated and also having made some very good friends on this site had the opportunity to ask questions to those that had similar surgeries as well.

    I know that you only asked about collars but my 1st surgery was so much different than this last in so many ways. I wanted to share my experience with others so that maybe I could be of help in another way as well.

    Good Luck;
    Dee :H
  • First ACDF I was in a soft collar. Surgeon told me initially that it would be the first 2 weeks. Turned into about 8.

    2nd c-spine surgery, hard collar for 6 weeks, then weaned off over next few weeks. Still occasionally use a soft collar, but it is for comfort only, and very infrequently at this point.

    I can't imagine not having a collar after c-spine surgery. I myself needed the extra support, and if I were to take it off for a few minutes, it didn't take long to want it back on.

    I would just suggest that if you are questioning your doctor's opinion on this, go get a 2nd opinion. At the minimum, this would reassure you. At most it would give you more information so that you will know what to do. I have never understood why some have you wear collars, some don't.

    I think that wearing a collar after surgery has more benefits than keeping your neck stabilized. It also puts those around you on notice not to bump into you. You won't have to worry about the impatient person in the shopping line pushing you around ;) .

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • dilaurodilauro ConnecticutPosts: 9,724
    a hard Philadelphia collar for about 7 or 8 weeks and then went to a soft collar for about 3 more weeks. Now, this was done in 1996 and 2000, so procedures and techniques may have improved. I still think that having the collar provides you with an 'extra' bit of protection to help with your healing process. Looking back, there was no way I could have got around without any collar.
    I agree with Cindy that you should raise this question again to your doctor and perhaps get a second opinion.
    I think having a list of Pros and Cons of having a collar or not would be very important for you.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hi Jim,
    Thanks for the response and information. I feel ok without a collar, just kind of concerned about hurting the chance of fusion or accidentally hurting myself. I will ask some questions on Monday when I go in to have my stitches removed. I did a lot of research on my doctor and trust that he knows what he is doing.
  • Hi Cath,
    Good luck on your upcoming surgery. If we can keep this topic going it will be interesting to see what type of differences we all experiance with collar/no collar and timing on collar. My big goal right now is fusion.
  • Good luck with the current fusion. Sounds like you have a very demanding job. How do they tell if the bone is fusing? I assume by taking an xray? I am hoping to see something happening fairly quickly or I will start worrying about fusion. I know that percent of fusion decreases with each level fused (part of the reason my doctor did 3 rather then 4 levels) but hopefully the bone stimulator offsets this,
  • After my first ACDF last November, the doctors had me in a hard collar while I was in a car or out and about where I could get bumped into. I used the hard collar in the car for 6 weeks and olny used the soft collar as I felt the need. My OS did not want me getting used to needing the collar to function. The second surgery in March was much more intense, Hard collar for 6 weeks in the car, but due to all the hardware, they felt that I could again use the soft collar as needed. I probably did wear the soft collar about 6 weeks, more as just in case than needed.
    I think that a lot of it has to do with your doctors and I am begining to think what area of the country you are in. You are right Cindy, the collar does keep most people from bumping into you.

  • Hi Cindy,
    I agree that wearing a collar has benefits but I am going to attempt to do this the way my doctor wants to. I think (I hope) I have fairly strong muscles in my neck. I have been doing neck exercises for the last 8 years in my attempt to delay the surgery I finally had this month. As I mentioned in another post it will be interesting for all of us to continue to compare results and see what kind of differences we get with the collar and without. Of course there are lots of other differences also like age, spine condition, smoke or don't smoke but still we should be able to get some idea.
  • As mentioned this will be an interesting one to keep track of.
  • Hi Mark,
    I like seeing comments like yours, since it's important to us to know that there is success down the road. I really hope that my surgery was a success and I get to provide positive feedback. So far I feel pretty good. Tired from not getting enough sleep but all in all not bad for 9 days post surgery.
  • My surgery is 10/15: 3 level (C4-7) ACDF with instrumentation. My NS said that if it were a 2 level he would say soft collar, but with 3 level and the length of my neck, I am going to be too unstable. He said 8 weeks hard collar. We'll see...
    Interesting all the different views for the same procedures.
  • I was fused 3 years ago 3-6 with instrumentation & cadaver bone. I am a smoking diabetic. I woke up in CCU with a soft collar, and the nurse threw it out! Said I didn't need it. Later, next day?, I got a J collar, and was told to wear it at all times, except in the shower. On release from hospital, they gave me another soft J type collar for shower. Trying to sleep with that J collar was a real challenge!! I don't move much when I sleep, so that lasted about 2 nights. I'd wear it during the day, or in the car, and after about 3 weeks of that, in Florida, in the summer, that was the end. I also had a bone stimulator to be used 30 min a day. I did that for about a month. OK, so I'm not the model patient. X-ray & MRI show the fusions are solid.

    Everything above, below, and around the fusions has gone to pot, but the fusions are great.
  • Well I have to say this is my second surgery and the first did not fuse the way it should of, it was not solid, and I had screws that were drilled into bone that was not solid.. My doctor calls me his special child, because they dont often see this happen 4 years later.... because I didnt fuse right he is not taking any chances of me not behaving and I also have had 6 levels fused, in all... I didnt have a collar at all the first time around, and now I wish I had of.. Each dr is different. I have had this surgeon for 4 years now and I love him.... Its interesting to see the different thoughts..... I have a aspen vistor collar, the newest in collars, Its really not that bad now that I have gotten used to it.... I dont smoke, but I am 50 and it will take me longer to fuse.... I almost came out with a HALO.... thank Jesus that did not happen....
  • See......what you say makes sense to me. The more levels the more unstable and yet here I am with 3 levels and no collar. I really HEAR you when you said you knew something was wrong. I had a herniated disc in my neck 8 years ago but decided on a conservative treatment at the time and things were basically ok (moderate pain on occasion) for a long time. Then over a year ago I started having problems with my arms and hands at night. I saw my doctor (just a regular doctor) and she just said I was "tired" from working on the computer all day. This went on for a long time and then in March all my finger tips developed numbness and pain and pain ran up/down my right arm and shoulder. This pain and numbness NEVER went away and I started seeing doctors. First my regular doctor who said pinched nerve then a neurogist who said carpel tunnel and did an EMG and had me wear hand splints for a month (and I do have carpel tunnel, moderate in my right hand and borderline in my left but that was not the issue). Finally the neurogist sent me for an MRI and the rest is history. By the way I actually could have had a 4 level ACDF because C6/7 is damaged but mild in comparison to C3/4 and C5/6. My NS said its a huge difference is difficulty and healing to go from 3 levels to 4 so he wanted to do 3. I talked to him about future problems because I really don't want this to be one of many surgeries. He said because of my age, I'm over 50 he felt I would be ok. If I was young he would have fused 4 levels. Boy did I get off the topic of collars. Sorry,
  • Hi Barb,
    I'm glad to hear you fused well but the fact that you say everything above and below the fusions has gone to pot is scary. This is of course the other issue for all of us with DDD and spinal problems. The stress the fused bone puts on the adjacent unfused levels. I hope things are not too bad for you. Are you considering additional surgery?
  • Hey there,

    When I had my first cervical surgery in January of this year, Posterior Cervical Foaminotomy of C 3-4 and 4-5, I was given a sof collar and I was in misery! Looking back now I wish I would have been in something more stable then the soft callar.
    I never really felt much better after that surgery and I was told way before the Foraminotomy that I would need Later Fusion.

    So months later I was still miserable and had no life pain every day. I decided to change from my NS to an Ortho spine specailist. I have bben treated much better by this practice and its medical professionals.

    When we decide to have the ACDF done I was told about the Apen collar I would need to wear for 4-6 weeks post op! My Ortho surgeon said that I will then go into a soft collar.

    I could not even think of having any cervical surgery without some sturdy type of support afterward.

    Yes, my collar is a pain in the you know where, but on the other hand I am gald to have it and if my surgeon had said no he does not use them I would have been a bit skeptical about having them do my sirgery.

    Different docs do things differently. I have no idea if any resaearch has ever been done on the advantages and disadvantages of having the hard coolar on after ACDF or not. Wonder if the was such research what were the success rates as the two options would have been compaired.

    Anyhow I have seen many on this board who have gone either route some siccessfull and some not. The human body is just amazing and ya never know what might happen!

    Hope you doing well today!

  • I wore an Aspen hard collar to ride in a car or sleep. Soft cervical collar the rest of the time. I had them on 24/7 for 6 weeks except to shower. It was wonderful getting rid of my "prison collar".
  • Hope your recovery is going well. I will be getting my stitches out on Monday and plan to ask some questions about the collar at that time. Not that I am looking for one, only that I want to do every single thing I can to make this surgery successful. Using the bone stimulator today and half way through it starting beeping low battery. Turns out I was just plugging it to recharge and it needs to be plugged in and the on button pushed. I don't remember the rep who delivered it telling me this but its not a big deal since its charged now and it holds its count from early and just continues to count down the 4 hours. I am so bored!!!! I am just not used to sitting around doing nothing and its raining and I can't even go for a walk.
  • How is your recovery going and what exactly did you have done?
  • Cadaver bone with plate and screws C5-6. NO Collar at all. Not even in car on way home from hospital. My neuro wanted me to move my neck as much as I could, which wasn't much. :))( 60 yr old diabetic smoker! And fused fine, thank the Lord O:)
  • Maggie,
    Thanks for posting. Its good to know that you had no collar and got good fusion. I've been worrying about moving my neck too much because I am unsure what is allowed and not allowed. The only instructions i recieved were no pull push lift 5+ lbs but nothing about neck movement. Sounds like you have a lot of other stuff going on from your profile. I hope you are feeling ok and pain is under control.
  • After reading all the above posts, sounds like my NS is pretty strict. I am 2 weeks post op 2 level ACDF with cages, plate and screws. I will be in a Aspen collar for 3 months 24/7. That includes showering and sleeping!! It would be more tolerable if it was winter time. Atleast my neck would be nice and warm. Lately it has been hot and sweaty!!
  • You must have my doctor, cause I have to stay in mine 24/7 for 3 months, and I have to wear it in the shower, I have extra pads, Have to hold my head while my hubby changes the pads for me. and then he puts the brace back on,., I think we are in the same brace, mine is a aspen visor,, it has a little button on the front so you can adjust it...
  • Did your surgeon tell you before surgery that his standard is 3 months in Aspen Collar after that kind of surgery? I'm just curious.

    I'm guessing my surgeon will be the same. So far every time I've seen him one of his secretaries gives me a pre-formatted letter step by step what is going to happen next. Plus, I have seen others coming in for appointments with Aspen Collars on.

    I'll know tomorrow. My DO thinks he will recommend 4 level C-3 thru 7 ACDF. I have bulging discs and bone spurs all thru those levels to varying degrees.

    I'll post after my appointment tomorrow with my surgeon on what he will be doing.

    Ken GreyEagle
  • I bet with all those levels you will have one, My doctor told me before hand, but He also was going to do a different approach and do 2 suguries front and back, at different times of course, but 3 weeks between, and after the last surgery I would come out with a halo... My neck is wacked and Now I have so many levels done...I have a really hard working job as chef and I have been in that sort of feild for 30 years, I have not done much justice to my back.... plus having DDD.......... Good luck tomorrow,
    ask lots of questions, I suggest you write them down so when you get in there you dont go blank.. I have a habit of doing that,...
  • Hi Cindi:

    Well, he knows he is going to acdf C-5/C-6. He wants a closed MRI for the rest as the current MRI was done on an Open MRI Machine and he feels the images are poor. Once I have that I hope he comes to a final full decision on how many levels he is doing.

    Chef? I'm amazed at your abilities! I have two pans going at once on the stove and I panic! LoL!

    Ken GreyEagle
  • I am in a Miami J collar for 12 weeks. In my case, 2 complete vertabrae (C-6/C-7) & 3 discs had to be removed. The only metal I have is a posterior rod & 8 screws holding in place 4-5 inches of bone graph. When I complained, I was told that "you're lucky I didn't put you in a halo."
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