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cervical fusions & no collar

diamondeddiamonde Posts: 185
edited 06/11/2012 - 8:27 AM in Back Surgery and Neck Surgery
Hi all, i've posted about this before, but at the time i was thinking i'd be in a collar after my ACDF, but i learned today when i met with NS that he doesn't recommend collars... so now i'm rejigging all of my mental planning about recovery at home. So for anyone who's had a cervical fusion AND who didn't wear a collar (at all or when sleeping) - i'd love to hear how you found sleeping after the op, what you had to do to get to sleep, where you slept... I) you get the idea :)

I'm about to go buy a recliner this weekend (thought with the collar that was gonna be the best way to go...) but if i don't need it now... jeeeeez would love to spend the money on something else if i don't need the recliner lol!! :D

Thanks for your support (and patience :-))
L4-L5 fusion 1998; ACDF C4-6 2008; DDD


  • Trying to educate myself..... what was the Dr's rationale for not requiring a collar at all?
  • dilaurodilauro ConnecticutPosts: 9,832
    The No Collar method seems to becoming more and more frequent.
    When I had my ACDF's (1996 and 2000), there was no option but a Hard collar.
    I've read different articles about this, trying to understand the logic. I guess I am still a fan of Collars and Hard Collars to start of with. To me that just ensures that you are not going to do anything to your neck that could impact the fusion. 6-8 weeks in a Hard Collar is a small price to pay for a solid neck. Then after the Hard Collar its on to a soft collar for a couple of weeks.
    But Physical therapists have always told me that they do not like the soft collars. They believe that just prevents you from building up your neck muscles. There is a point post surgery when you can start to build up your neck muscles to avoid problems.
    This is only my personal opinion based on the surgeries and recovery I have gone through.
    I would always listen to what my doctor tells me and if its no collar, then be it no collar. However, on the other side, I never just do what is told to me, I question it...
    No harm in asking your doctor "Why no collar?, What IF I had a collar?"
    The more you know about the procedure and recovery the better you will be.
    Good luck
    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
  • I had C5/6 ACDF on March 12, 2008 and my doctor did not recommend a collar. He said he did not recommend a collar because first the fusion with the plate a screws is very, very strong and second he did not want my neck muscles to get weak.
    I did sleep in my recliner on and off the first few weeks. I also slept in my bed some too, sometimes start in bed and end up in the recliner.
    Diamonde - I would go ahead and purchase that recliner, it made a difference for me. I hope it helps you.
    I no longer have any pain in my neck or shoulders and have no numbness in my arm or fingers.
    I hope this helps you. PM anytime.
    Take care,
  • My NS is of the same thinking as Poollady's surgeon. He feels the hardware holds everything in place just fine and that a collar results in atrophy, weak neck muscles and overall harder recovery. He sent me home with orders to rotate, twist, flex and extend my neck carefully in all directions from day one. I was able to maintain my neck strength, never lost any ROM, and never had to have PT. Doing my ROM exercises with hot water running on my neck in the shower actually felt good. I was back to work part-time at two weeks, full time at 4 weeks, off all pain meds at 2 months and now at 3 1/2 months out it feels like I never had anything done at all.

    Before surgery, I was in a soft collar. I actually wore it backwards because that held my neck at just the right angle (slightly forward) to relieve some of the pinched nerve pain. Immediately after surgery, I slept in a slightly elevated position, propped up with pillows on the couch (I don't own a recliner). I was on plenty of narcotics, muscle relaxers, heat and ice at that point. In a couple days I could sleep fully reclined and within 10 days I was back in my waterbed. At six weeks out, I was able to sleep on my stomach again with my head turned all the way to the side, which was one of the happiest nights of my life!

    Good luck and feel free to post or PM any questions!
  • Hi Diamonde

    I am 13 days post op 2 level cervical fusion with cages. My NS also said no to a collar and I am healing perfectly. Are you buying a recliner just because of the surgery? I would say you really dont need to. I slept in bed on my one pillow the first night home from the hospital. Im not going to lie, it was a BIT uncomfortable, but by the 3rd night i was sleeping just fine on my side with one pillow as level as I can get. I expected the recovery to be long slow and painful and i was wrong on all counts (it could also just be my account, everyone heals differently). I was driving 4 days later and doing all my normal activities sans ANY lifting. I actually had my first post op appt this morning and he says Im doing excellent! Good luck to you :) and I hope some of the advice helps :)
  • when my nurses said my surgeon was VERY conservative, they weren't kidding ;) He's only 35 years old LOL! I would have expected it from an older / more experience one.

    Anyhoo, I am 14 weeks post op one level ACDF at C6/C7 with titanium plate, screws and a PEEK Cage. I wore my collar for 12 weeks and now in a soft one for 6 weeks (3 left to go). He would have NORMALLY let me out at 6 weeks - but I am fusing very slow.

    Each surgeon is SO different, it's scary. I was not allowed to drive for 6 weeks nor did I work for 8 weeks. NO lifting over 20 lbs.

    GOOD LUCK to you.
  • With plating and screws in May of 2007. No collar pre or post-op. My NS said the same thing about the plating and screws with regard to strength. I fused great but, HERE'S the thing...I believe with all my heart that NOT wearing a collar post op caused the minor bulges above and below the plating that weren't there pre-op.

    My rationale is that the movement allowed without the collar put the stress on the concurrent vertabrae...with the collar no movement no stress until a fusion starts. It may seem a little off base but, it's all I can deduce, other than the fact that I have weak discs, which could be true as I have since developed herniations in my T and L spine.

  • Hi everyone,

    Thanks so much sharing all of your experiences of post-op life without a collar. My NS said exactly the same as everyone elses who didn't have to wear the collar... Part of me is glad because they sound dreadful!! But also bit nervous given so many people seem to wear them. I think there is logic to the use it or lose it theory re neck muscles... but... what if!

    And to those who asked... yes... I'm thinking about buying a recliner JUST for this! Its for many reasons which make sense to my own life. My thinking on it is: 1) I'd hate to not have it and be miserable and a bit impaired to go out and look for one myself 2) I'm worried about not being able to sleep comfortably and if i can't sleep i'll want to watch tele.... and no tele in the bedroom - soooo solution if i can't sleep i'll be downstairs... thus the recliner! I) (female logic aint it great!!) 3) IF (big if) recovery takes longer than expected - i've heard from several people that they slept in their recliners for weeks after (may have to do with collars DK? 4) be a nice addition to the sitting room! :D In fairness, if i wasn't having the op, i'd choose to spend my money on something else (like a holiday after all this!! LOL), but it seems for me to make the most sense... if i only use it for 3 days... like i said... i'll have a lovely new comfy place to curl up - which may be better for me than curling up on the sofa... better posture and all that :>

    Soooo guess i'll have a friend drive me round the furntiture stores on saturday! B)
    L4-L5 fusion 1998; ACDF C4-6 2008; DDD
  • I wasn't given a collar for the same reasons as everyone else. As for sleeping, I bought a used recliner off of craig's list. I used it quite a bit for napping, resting, etc... I slept on it on & off for the first few weeks, whenever I couldn't handle the bed. I think it is a very good idea for you to get one, as it really helped me out a lot. I opted for a used one, though because I couldn't really afford a new piece of furniture right now. Good luck to you!
  • Dave had to try out MANY recliners before he found one that was the most comfortable for him. I would suggest waiting until post surgery to try them out. They are all so different!! JMO

    Linda MI
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