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Collars after Cervical surgery .... Yes or No

AnonymousUserAAnonymousUser Posts: 49,000
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. 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?
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  • 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 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!
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  • dilauroddilauro ConnecticutPosts: 12,303
    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.
  • 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.

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