Postoperative bracing after spine surgery for degenerative conditions: a questionnaire study

Brief review

이 연구는 한 학회에 참가한 척추전문의들에게 본인의 환자에게 보조기를 사용하는 것과 관련하여 설문을 진행한 질의연구 입니다. 

설문의 초점은 외과의들이 환자 수술 후에 사용하는 보조기의 종류, 치료기간, 사용이유 등에 관한 것 입니다.

응답자들이 수술을 마친 본인의 환자들에게 보조기를 사용 할 때에, 고정을 위한 가장 적절한 종류, 기간, 적응증에 따른 합의가 부족하다는 결론입니다.

*Title: Postoperative bracing after spine surgery for degenerative conditions

: a questionnaire study

퇴행성질환을 위한 척추수술 후의 보조기 착용: 질의 연구

*Author: Jesse E. Bible, Debdut Biswas, Peter G. Whang, Andrew K. Simpson, Glenn R. Rechtine, Jonathan N. Grauer

*Bibliography: The Spine Journal Volume 9, Issue 4 ,Pages 309-316, April 2009

Background context:

-A variety of orthoses are routinely applied after spinal procedures.

-But the proper indications for postoperative bracing are not well established.

Purpose

To assess the postoperative bracing patterns of spine surgeons.

Study design/setting

Questionnaire study

Patient sample

Spine surgeons attending the “Disorders of the Spine” conference (January 2008, Whistler, Canada).

Outcome measures

Frequencies of bracing after specific surgical procedures.

Methods

▶Subject: spine surgeons attending the “Disorders of the Spine” conference.

▶Questionnaire contents: typically immobilize patients after specific spinal procedures, the type of orthosis used, the duration of treatment, the rationale for bracing.

Results

-Ninety-eight of 118 surgeons completed the survey (response rate: 83%).

1. The frequency of bracing in academic and private/ in orthopedic and neurosurgical practices

--> similar

2.The difference in the bracing tendencies of fellowship and non-fellowship trained surgeons: -----> statistically significant (61% vs. 46%, p<.0001).

3. The duration (clinical experience): no influence the propensity of surgeons to use orthoses.

4. Employed more regularly: after cervical surgery > lumbar surgery (63% vs. 49%, p<.0001).

6. In the anterior cervical spine, orthoses were used more often as the complex procedure.

(increased single --▶ multilevel constructs (55% vs. 76%, p<.0001) )

7. The frequencies of bracing in noninstrumented and instrumented lumbar fusions

-->not significantly different.

Conclusions

-Most of the respondents brace their patients postoperatively, there is an obvious lack of consensus regarding the most appropriate type, duration, and indications for immobilization.

-Clinical studies may play a helpful role in evaluating the efficacy of postoperative bracing protocols.