Document Type
Article
Publication Date
10-1-2021
Abstract
Background: Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs.
Methods: Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013-2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days.
Results: Amongst the study population, 936 were braced and 44 were not braced. There was no difference between the braced and unbraced cohorts regarding LOS (P = .106), discharge disposition (P = .898), 30-day readmission (P = .434), and 30-day ED evaluation (P = 1.000). There was also no difference in total cost (P = .230) or QALY gain (P = .740). The results indicate a significantly lower likelihood of SSI in the braced population (1.50% versus 6.82%, odds ratio = 0.208, 95% confidence interval = 0.057-0.751, P = .037). There was no difference in relevant comorbidities (P = .259-1.000), although the braced cohort was older than the unbraced cohort (63 versus 56 y, P = .003).
Conclusion: Bracing following multilevel posterior lumbar fixation does not alter short-term postoperative course or reduce the risk for early adverse events. Cost analysis show no difference in direct costs between the 2 treatment approaches. Short-term data suggest that removal of bracing from the postoperative regimen for PLF will not result in increased adverse outcomes.
Publication Title
International Journal of Spine Surgery
ISSN
2211-4599
Publisher
The International Society for the Advancement of Spine Surgery
Volume
15
Issue
5
First Page
915
Last Page
920
DOI
10.14444/8119
Recommended Citation
Dimentberg, R., Sinha, S., Glauser, G., Caplan, I. F., Schuster, J. M., McClintock, S., Yoon, J. W., Marcotte, P. J., Ali, Z. S., & Malhotra, N. R. (2021). Short-Term Impact of Bracing in Multi-Level Posterior Lumbar Spinal Fusion. International Journal of Spine Surgery, 15(5), 915-920. http://dx.doi.org/10.14444/8119