PURPOSE Even though the anterior cervical discectomy and fusion (ACDF) is one of the most common spinal procedures, a consensus on the real need for prescribing a cervical collar (CC) after surgery is still missing. In fact, the role of external immobilization in decreasing non-fusion rate and implants displacement has not been clarified yet. METHODS This study was conducted according to the PRISMA statement. Six different online medical databases were screened. Papers reporting the neck disability index (NDI), cervical range of motion (RoM) and fusion rate after ACDF without plating, on single or multiple levels, for cervical spondylosis were considered for eligibility. RESULTS There were no significant differences in terms of NDI scores at 2 weeks (WMD = 4.502; 95% CI - 5.953, 14.957; p = 0.399; I2 = 65.14%; p = 0.090) and 1-year (WMD = 2.052; 95% CI - 1.386, 5.490 p = 0.242; I2 = 0%; p = 0.793), RoM reduction at 1-year (WMD = 1.597; 95% CI - 5.886, 9.079; p = 0.676; I2 = 0%; p = 0.326) or fusion rate (OR = 1.127; 95% CI 0.387, 3.282; p = 0.827; I2 = 2.166%; p = 0.360). CONCLUSIONS The use of a CC after ACDF without plating on single or double levels for cervical spondylosis seems not supported by scientific evidence. These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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颈椎前路颈椎间盘摘除术和无单板或双板无钢板融合术在颈椎功能恢复和融合中的作用：系统评价和荟萃分析。

目的尽管颈椎前路椎间盘切除融合术（ACDF）是最常见的脊柱手术之一，但对于手术后真正需要开颈托（CC）的真正共识仍未达成共识。实际上，尚未阐明外部固定在降低非融合率和植入物移位方面的作用。方法本研究是根据PRISMA声明进行的。筛选了六个不同的在线医学数据库。考虑单次或多次报告颈椎病的颈部残疾指数（NDI），颈椎活动范围（RoM）和ACDF不用钢板后的融合率的论文均符合资格。结果在2周时（WMD = 4.502; 95％CI-5.953，14.957; p = 0.399; I2 = 65.14％; p = 0.090）和1年期（WMD = 2.052; 9％CI-5.953，14.957）95％CI-1.386，5.490 p = 0.242; I2 = 0％；p = 0.793），1年RoM降低（WMD = 1.597; 95％CI-5.886，9.079; p = 0.676; I2 = 0％; p = 0.326）或融合率（OR = 1.127; 95％CI 0.387， 3.282； p ＝ 0.827； I 2 ＝ 2.166％； p ＝ 0.360）。结论在ACDF后未进行单次或两次水平电镀治疗颈椎病中使用CC似乎没有科学证据支持。这些幻灯片可以在电子补充材料下找到。