Is External Cervical Orthotic Bracing Necessary After Posterior Atlantoaxial Fusion with Modern Instrumentation: Meta-Analysis and Review of Literature

After C1-2 fusion with modern instrumentation, ECO may be unnecessary (class III). Some centers recommend ECO use with patients with softer bone quality (class IV). Prospective, randomized studies with validated radiographic and clinical outcome metrics are necessary to determine the utility of ECO after C1-2 fusion and its impact on patient comfort and cost.