PT  - JOURNAL ARTICLE
AU  - Dimentberg, Ryan
AU  - Sinha, Saurabh
AU  - Glauser, Gregory
AU  - Caplan, Ian F.
AU  - Schuster, James M.
AU  - McClintock, Scott D.
AU  - Yoon, Jang W.
AU  - Marcotte, Paul J.
AU  - Ali, Zarina S.
AU  - Malhotra, Neil R.
TI  - Short-Term Impact of Bracing in Multi-Level Posterior Lumbar Spinal Fusion
AID  - 10.14444/8119
DP  - 2021 Oct 01
TA  - International Journal of Spine Surgery
PG  - 915--920
VI  - 15
IP  - 5
4099  - https://www.ijssurgery.com/content/15/5/915.short
4100  - https://www.ijssurgery.com/content/15/5/915.full
SO  - Int J Spine Surg2021 Oct 01; 15
AB  - 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.