Liedewij Bogaert1, Peter Van Wambeke2, Tinne Thys2, Thijs Willem Swinnen3,4,5, Wim Dankaerts4, Simon Brumagne2,4, Lieven Moke6,7, Koen Peers2, Bart Depreitere8, Lotte Janssens4,9. 1. Division of Physical Medicine and Rehabilitation, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. liedewij.bogaert@hotmail.com. 2. Division of Physical Medicine and Rehabilitation, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 3. Division of Rheumatology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 4. KU Leuven - Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, P. O. Box 1501, 3000, Leuven, Belgium. 5. Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Herestraat 49, P. O. Box 813, 3000, Leuven, Belgium. 6. Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 7. Division of Orthopaedics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 8. Division of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 9. Reval Rehabilitation Research Center, Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium.
Abstract
PURPOSE: Bracing is frequently prescribed following lumbar surgery for degenerative conditions. However, previous studies failed to demonstrate the advantage of postoperative lumbar bracing in both short- and long-term outcome in terms of pain, quality of life and fusion rate. The purpose of this study was to assess the prescription patterns and rationale for postoperative bracing amongst spinal surgeons in Belgium. METHODS: A 16-item online survey was distributed by email to spinal surgeons affiliated to the Spine Society of Belgium (N = 252). RESULTS: A total of 105 surgeons (42%) completed the survey. The overall bracing frequency following lumbar surgery was 38%. A brace was more often prescribed following the fusion procedures (52%) than after the non-fusion procedures (21%) (p < 0.0001). The majority of surgeons (59%) considered bracing after at least one type of lumbar surgery. Orthopaedic surgeons (73%) reported a significantly higher rate of prescribing postoperative bracing compared to neurosurgeons (44%) (p = 0.003). Pain alleviation (67%) was the main goal for prescribing a postoperative brace. A total of 42% of the surgeons aimed to improve fusion rate by bracing after lumbar fusion procedures. A quasi-equal level of the scientific literature (29%), personal experience (35%) and teaching from peers (36%) was reported to contribute on the attitudes towards prescribing bracing. CONCLUSIONS: Postoperative bracing was prescribed by Belgian spinal surgeons following more than one-third of lumbar procedures. This was underpinned by beliefs regarding pain alleviation and higher fusion rate. Interestingly, based on the scientific literature these beliefs have been demonstrated to be false. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: Bracing is frequently prescribed following lumbar surgery for degenerative conditions. However, previous studies failed to demonstrate the advantage of postoperative lumbar bracing in both short- and long-term outcome in terms of pain, quality of life and fusion rate. The purpose of this study was to assess the prescription patterns and rationale for postoperative bracing amongst spinal surgeons in Belgium. METHODS: A 16-item online survey was distributed by email to spinal surgeons affiliated to the Spine Society of Belgium (N = 252). RESULTS: A total of 105 surgeons (42%) completed the survey. The overall bracing frequency following lumbar surgery was 38%. A brace was more often prescribed following the fusion procedures (52%) than after the non-fusion procedures (21%) (p < 0.0001). The majority of surgeons (59%) considered bracing after at least one type of lumbar surgery. Orthopaedic surgeons (73%) reported a significantly higher rate of prescribing postoperative bracing compared to neurosurgeons (44%) (p = 0.003). Pain alleviation (67%) was the main goal for prescribing a postoperative brace. A total of 42% of the surgeons aimed to improve fusion rate by bracing after lumbar fusion procedures. A quasi-equal level of the scientific literature (29%), personal experience (35%) and teaching from peers (36%) was reported to contribute on the attitudes towards prescribing bracing. CONCLUSIONS: Postoperative bracing was prescribed by Belgian spinal surgeons following more than one-third of lumbar procedures. This was underpinned by beliefs regarding pain alleviation and higher fusion rate. Interestingly, based on the scientific literature these beliefs have been demonstrated to be false. These slides can be retrieved under Electronic Supplementary Material.
Entities:
Keywords:
Low back pain; Orthosis; Postoperative period; Practice pattern; Spine
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