Bracing Following Transforaminal Lumbar Interbody Fusion is not Necessary for Patients With Degenerative Lumbar Spine Disease: A Prospective, Randomized Trial. Issue 9 (November 2018) - Yao, Yu-Cheng
Abstract : Study Design: This is a prospective, randomized trial. Objective: This study aimed to evaluate the outcome of bracing following transforaminal lumbar interbody fusion (TLIF) in patients with degenerative lumbar spine diseases. Summary of Background Data: Bracing following spinal fusion for lumbar degenerative disease is common. However, the necessity of postoperative bracing is still controversial. A paucity of high-quality studies have assessed the efficacy of bracing. Materials and Methods: In total, 90 patients with degenerative lumbar disease receiving instrumented TLIF were randomly assigned to brace and no brace groups for postoperative care. Patients in the brace group were instructed to wear a rigid brace full-time for 12 weeks. Patients in the no brace group were instructed to wear a soft corset for 2 weeks, after which it was weaned off. In all patients, the Visual Analogue Scale and Oswestry Disability Index scores were evaluated preoperatively; postoperatively; and at 6 weeks, 3, 6, and 12 months of follow-up. The fusion rates, complications, and reoperation rates were recorded. Results: In total, 44 patients were assigned to the brace group (mean age, 69.2±10.7 y), and 46 were assigned to the no brace group (mean age, 68.8±11.9 y). All patients received at least 12 months of follow-up. There were no significant differences between the 2 groups with regard to patient demographic characteristics. The Visual Analogue Scale and Oswestry Disability Index scores at each follow-up were not significantly different between the 2 groups. The fusion rate and complications at the 12-month postoperative follow-up were not significantly different between the 2 groups. Conclusions: Our study showed that in patients with degenerative spinal disease who receive TLIF, wearing a rigid brace postoperatively is unnecessary. In addition, the fusion rate was not related to bracing, and there were no complications or reoperations whether a brace was worn. Level of Evidence: Level II—therapeutic.