Cervical Orthosis Versus no Orthosis Following Multi-level Posterior Cervical Fusion
Cervical Orthosis Versus no Orthosis Following Multi-level Posterior Cervical Fusion
Use of cervical orthosis after instrumented posterior cervical spinal surgery is still widely
 practiced even though modern fusion techniques likely do not require additional stabilization
 from an external orthosis. This is a single, centre randomized, non-blinded equivalence
 trial. Patients undergoing multi-level posterior cervical fusion will be randomized to
 cervical orthosis (CO group) or no orthosis (NO group). Immediately following surgery
 patients in the CO group will be fitted with a Philadelphia collar prior to being transferred
 to the recovery room. On the patient ward a physiotherapist will fit the patient with a
 Cervimax/Aspen/Miami J collar which will be worn at all times for 6 weeks according the
 standard of care. The NO group will have no specific precautions applied to their neck range
 of motion. Outcomes will be assessed prior to surgery, on the second day after surgery, and
 at 2, 4, 6 and 12 weeks after surgery. The primary outcome will be neck pain score on the
 numerical rating scale (ranging from 0-10 with higher scores indicating more severe pain)
 during the first 4 weeks after surgery with an equivalence margin of 2.0 points. Secondary
 outcomes will be neck disability, general health, treatment satisfaction, pain medication
 use, adverse events, neck range of motion, time meeting discharge status, and compliance in
 wearing the collar.
Inclusion Criteria:

 1. Undergoing multi-level (2- or more level), open, posterior cervical fusion which may
 extent into the second thoracic vertebrae (C1-T2)

 2. Able to consent to inclusion in the study

 3. 18 years of age and older

 Exclusion Criteria:

 1. Spinal cord injury

 2. Primary cervical spine infection

 3. Cervical spine tumor

 4. Inability to comprehend patient rated outcome instruments

 5. Substance abuse

 6. Dementia

 7. Psychosis

 8. Previous surgery at same level