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  • Donald Corenman
    Post count: 52

    I am 52 and scheduled for c4-5 w/fusion next week, currently have desk job no lifting required, Does this surgery require neck brace in all cases? Also if one had a multi-level fusion would two plates be used or would it require different method? I understand lots of other variables play into picture, just wondering in general.

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    Donald Corenman, MD, DC
    Post count: 8459

    An ACDF at C4-5 can be performed with the graft being allograft (cadaver bone), autograft (your own bone) or a plastic cage with shavings and BMP (bone morphogenic protein). Each method has its own type of healing potential and stability. In all cases, if a plate is used in the front of the neck, the plate will confer immediate stability (as long as the carpentry of the graft and the surgical bed are well done). If the graft fits perfectly and the plate is applied correctly, there really is no need for a collar at all. I do use a collar for my patients for the first week just to remind them they had surgery and to comfort the achy muscles.

    If more than one level is done, the plate would simply be longer in length. The recovery period would be about the same and the need for the collar is still questionable.

    I have a different algorithm than some surgeons for post operative recovery and have my patients engage in immediate post operative exercises.This may not be how your surgeon operates so I don’t recommend doing this unless you get your surgeon’s approval. If you are interested- please go to my web site ( and look under the header “Pre & Post OP”, the subheading “Post Operative Rehabilitation” and finally “Neck Exercises”. I immediately have my patients start “Around the Worlds” and after one week, “Yes and Nos”. Do not do “Neck Situps” until you neck is fully healed.

    Good luck!

    Dr. Corenman

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