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    Old 02-07-2012, 06:15 PM   #1
    joaneeo
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    Why wear a collar when you have hardware?

    I'm a little confused about this. If I'd had a spinal fusion with plates and screws which is supposed to stabilize the neck why do I have to wear a collar? The nurse who did my pre op said my doctor was conservative about the surgery-is this just him being conservative?

    Last edited by Administrator; 02-24-2012 at 12:02 AM.

     
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    Old 02-08-2012, 05:42 AM   #2
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    Re: Why wear a collar when you have hardware?

    Hello, the way my neuro explained is that the new bone growth will grow around that plate hence fusing and wearing the brace keeps your head stable and from moving too much or too soon resulting in damaging the new growth or the plate shifting.

    Take care,
    Bunz

    Last edited by Administrator; 02-24-2012 at 12:03 AM.

     
    Old 02-08-2012, 05:48 AM   #3
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    Re: Why wear a collar when you have hardware?

    The surgeon who did my ACDF many years ago said that the collar - even a soft collar - was unnecessary, at least not after the first few days. Said that's what the plates are for. He was a very experienced spinal surgeon.

    Last Spring, when I was looking into another ACDF (bi-level) or a laminoplasty, the surgeon who recommended the ACDF said I'd have to wear a collar for two months. That surgeon was fairly young, didn't know how to do laminoplasties, and was working in a clinic that's in-network for Blue Cross (which, to my mind, means they are hard up for business).

    When I went with the laminoplasty (with a very highly recommended surgeon - not Blue Cross), I had a soft collar on immediately after the surgery, and that evening the surgeon came in a TOOK IT OFF. He says a little movement is better than being constricted.

    So there you have both sides of the argument. A cynical person (like me) might suspect that collars have a lot more to do with possible malpractice suits than with good medical practice.

    Last edited by WebDozer; 02-08-2012 at 05:51 AM.

     
    Old 02-08-2012, 03:50 PM   #4
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    Re: Why wear a collar when you have hardware?

    Quote:
    Originally Posted by WebDozer View Post

    So there you have both sides of the argument. A cynical person (like me) might suspect that collars have a lot more to do with possible malpractice suits than with good medical practice.
    Well, when my Dad talked to the surgeon after the surgery and he said at least 4 weeks.(at least that's what he told me after the surgery, now he can't "remember") It's his PA that is saying 12 weeks.

    I'm a cynic too and I've been reading up on this collar vs no collar thing and the general consensus is that it really makes no difference whether you have one because fusion success rates are about the same.

    It's like walking. I can't walk outside because it's too cold and snow on the ground so I went to use the treadmill in the clubhouse yesterday. I hurt when I was done-never had that problem after walking outside.

    Last edited by joaneeo; 02-08-2012 at 03:53 PM.

     
    Old 02-09-2012, 10:20 AM   #5
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    Re: Why wear a collar when you have hardware?

    I only had to wear my collar for two weeks. Was released to drive then too.
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    Old 02-12-2012, 04:54 PM   #6
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    Re: Why wear a collar when you have hardware?

    I am glad I took the time to go on the computer tonight as I was sitting her wondering about the whole collar crap. Excuse the expression. My NS has me in a vista aspen collar for 6 weeks and I am 2 1/2 weeks post op. I woke up after surgery with the collar with no prior fitting before the surgery. When I woke up in the hospital the collar was on but pretty loose. When I got home I didn't know what to do because the discharge nurse was no help. I felt like a turtle and was always pulling my head into my collar and did call back to the NS nurse a few days later who told me my chin should rest and it should be snug but not to tight. So for over 2 weeks my neck has been under terrible stress because I am constantly fighting the collar. I either have my head tilted back or my chin tucked in. The pain is worse with this collar. I have only taken it off to shower or change the pads. It feels good to have it off but I am following the orders to wear the collar. I am afraid to call the NS nurse as I feel when I call there they think I am being a crazy patient. To me it feels like the collar is causing more harm than good. We all know our own bodies and I feel that the fusion is not healing right as I am putting more stress on the neck and guess what even in the collar I bend and turn my neck.

    So does anyone else feel this way? Please help.

    Last edited by Administrator; 02-24-2012 at 12:03 AM. Reason: spelling

     
    Old 02-13-2012, 05:43 PM   #7
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    Re: Why wear a collar when you have hardware?

    Sorry it took so long to reply Jas. I have to wear the collar at ALL times for 12 weeks-I have a philadelphia one for showering which is plastic one.
    I've adjusted the front of my collar so there is only a small portion of the pad sticking out of the plastic which seems to help me. If you think the collar is too big call the NS office and tell them.

    Myself, I've adjusted to it to the point where I've accepted it. Sitting around with a crappy attitude like I had only made me worse. I've been worrying about the impending legal action against the dude that hit me and getting angrier but like someone said, sitting around and dwelling on the past isn't going to help me heal. I think my surgeon knows what he's doing so I'll patiently wear the collar for the next 7 weeks. I have my 2nd post up next Tuesday and my first xray on Monday. I've been keeping myself busy by posting great reviews about the surgeon I had and catching up on old movies and tv shows. I basically got myself out of the "funk" I was in and I feel better emotionally.

    And like I said in my other posts-at least that god awful stabbing pain is gone from my neck shoulders and arms. If you look on the bright side of the whole thing at least they stopped the situation from progressing and I'm thinking that I'm finally gonna have my life back. I decided against the meniscus surgery for the time being because this one just took so much out of me. As long as it stays painless no one's touching. Four surgeries in 2 years is enough for me.

    I hope things look up for you soon. It's not good for the body and mind to be depressed while healing from this type of surgery.

     
    Old 02-13-2012, 08:00 PM   #8
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    Re: Why wear a collar when you have hardware?

    okay I feel better knowing my collar only has to be on for 6 weeks. My NS lets me take mine off for baths and showers. So I am thankful for that. His nurse also told me I could take it off for a few minutes for a little light massage. I make sure if I do take it off that I am sitting down and with no distractions to make me quickly turn my head. I have days of depression too and it is hard not to but then the next day comes and it is a whole different day with a better outlook. I was just thinking that back about 15 years ago I had some major stomach surgery and went back to work within a week and a half with staples in my stomach. I laugh now because I was in my late 20's - early 30's and bounced back with no problems. It is true the older we are the harder it is to bounce back. I am 47 and I spend my time thinking how I will treat my body in the future as to not end up with another herniated disc. For now I have stopped smoking and working on losing 10 or 15 lbs. So I feel that is a positive start. I hope your days get better. I think my 2 house cats are wondering what the hell I am doing home daily and will be really freaked when I go back to work. I always wondered what my cats did all day long and now I know. They do nothing at all!!! Sorry I just had to add some humor. Take care and chin up (if you can in the brace). I am sending smiles your way.

    Last edited by Administrator; 02-24-2012 at 12:04 AM.

     
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    Old 02-14-2012, 08:59 PM   #9
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    Re: Why wear a collar when you have hardware?

    I had major stomach problems and the route I had to get to point a to z was similar as the spine surgery because I had no health insurance then either. I suffered for years with a bad stomach and when I started to get these really bad stabbing pains I went to the hospital. If I had insurance I would have been admitted to the hospital the first visit but I wasn't. I suffered for several months until an austute NP said she thought I might have an ulcer. She used to work in a gastroenterologist office and she said she could tell from the way my breath
    smelled.

    I had a barium and she calls to tell me I had the biggest bleeding ulcer she has ever seen in my duodenum. She had already started me on the medication when she suspected it. The pain from that was pretty bad too-I spent days in bed because it was so untolerable. My neurosurgeons PA said I have a high sensitivity to pain.

    When you get depressed just do what I do-remember that the awful stabbing pain is GONE. I also don't think using the computer is the best thing either. Today I went for a walk-it was nice for a change and then came home and watched a movie. It was just a nice day which has been the way since Sunday.

    I plan on staying positive and working through the bad thoughts, I haven't had them since last week so I think I can pull through this once again. I think I am a strong person even though I don't have a strong support system. Sometimes you have to take a look back and find small things to make your present situation look alright. When I had my surgeries on my feet I couldn't take a shower for 2 weeks each time and when I broke my leg it was 4 weeks. At least I don't have THAT on my not to do list. Not being able to take a shower for that long, especially in the summer and spring, can be pretty yucky.

    But the collar doesn't bother me now. Life could be worst-I might not have ever found a Neurosurgeon to help me. I might still be walking around with painful toes if I hadn't changed providers.

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    Old 02-14-2012, 10:07 PM   #10
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    Re: Why wear a collar when you have hardware?

    I am usually on the Back board and have lumbar issues rather than cervical, but I just wanted to add my two cents.

    While it is true that hardware is designed to hold the patient together and was designed to stabilize the area while it heals, rather than having to resort to a brace, I think most surgeons use braces now just as a reminder to patients to immobilize the area as much as possible.

    A fusion is the same healing process as healing a broken bone. In most other body parts, the broken bone is cast so that the two ends cannot move while the new cells are knitting together.

    The way I look at it is that having a fusion is something none of us care to repeat if at all possible. To that end, why not be as careful as possible? Why not take precautions in an attempt to ensure the best possible outcome. Even though six or eight or twelve weeks may seem like an uncomfortable eternity, when looking at the big picture, it is a small price to pay to give yourself the best chance at a successful fusion.

    When I had my first lumbar fusion, my surgeon did not believe in the use of a brace for all the reasons that other posters have mentioned. 20 months ago, that fusion was added on to, one level up and down from the original surgery. I used a different surgeon who always uses a brace. We discussed the reasons for this on several occasions and he was careful to explain his reasoning since he was familiar with my first surgeon and the details of my surgery.

    Having now had surgery both ways -- with and without the use of a brace, I actually prefer the brace. I thought I was being so careful with my first surgery but while I was wearing the brace, I realized how much I had inadvertently "broken" the rules -- in the case of lumbar surgery, bending, twisting or reaching up or to the side....Not only does the brace serve as a reminder of "the rules," but it also prevents all those little movements that we make without thinking. Does it harm anything when we forget? Probably not...but who wants to take the chance?

     
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    Old 02-14-2012, 10:40 PM   #11
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    Re: Why wear a collar when you have hardware?

    Thanks Teton-that's how my attitude has become even though I have if off for a while and am using a heating pad because the muscles are spasming in the back of my neck and the heating pad worked before. Your story about your first fusion only makes me feel better and as acynic I could also say they reason why they don't want to use a brace is so you're a repeat customer. My NS has been doing this for 31 years and he has had no malpractice or disciplinary actions. He's been involved in deep brain stimulation for Parkinsons and other diseases like that.

    And you know what? Your logic makes sense! I consider myself very lucky to have this man as my NS after hearing the horror story of a man who went to one of the ortho's here.

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    Old 02-15-2012, 06:35 AM   #12
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    Re: Why wear a collar when you have hardware?

    My ns surgeon only had me wear a soft collar for 2 weeks then did not want me to wear anymore. Not sure why the difference, I think he wanted to get those muscles working & loose as soon as possible. But I'm not sure he was right on that one thing, I quit wearing it( & was glad too cause I hated it) but the last few days my neck has been really sore, like I'm moving it too much& it's very hard not to turn your head fast without it! You don't mean too but when my grandkids are here & holler or say something, I find myself doing it & not realizing it until it hurts. So anyway I'd do what your ns says rather than take any chances! Good luck!

     
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