Topics

Is Postoperative Bracing Necessary After Spine Surgery for Degenerative Conditions

2018-06-25 04:40:12 | BioPortfolio

Summary

This study was started from Oct. 2015. This study aimed to evaluate the outcome of bracing following transforaminal lumbar interbody fusion (TLIF) in patients with degenerative lumbar spine diseases.

Description

The inclusion criteria were age older than 18 years and undergoing TLIF for degenerative lumbar disc disease, spinal stenosis, or spondylolisthesis. Those who had spinal fracture, spinal infection, spinal tumor, and a history of previous spinal surgery; and those who were lost to follow-up or failed to complete the questionnaires were excluded.

Patients eligible for the study were selected by an independent research assistant. The study was explained, and informed consent was obtained from patients before the surgery. Using a randomization sequence, the patients were assigned to the brace or no brace group. The attending surgeons and patients were blinded before the surgery.

Patients in the brace group were instructed to wear a rigid brace (Knight-Taylor [chairback] brace) full-time for 12 weeks, except when bathing or lying in bed. Patients in the no brace group were instructed to wear a soft corset for 2 weeks, after which it was weaned off. All patients started wearing the brace or corset during their first ambulation out of bed following drainage tube removal after the surgery.

The success of interbody fusion was evaluated by computed tomography (CT) at the 6-month postoperative follow-up using the Brantigan-Steffee-Fraser (BSF) classification6. Radiographic fusion (BSF-3) was defined as bone bridging at least half of the fusion area with at least the density originally achieved at surgery. Radiographic locked pseudarthrosis (BSF-2) was indicated by lucency visible in the middle of the cage with solid bone growing into the cage from each vertebral end plate. Radiographic pseudarthrosis (BSF-1) was indicated by collapse of the construct, loss of disk height, vertebral slip, broken screws, displacement of the cage, significant resorption of the bone graft, or lucency visible around the periphery of the graft or cage.

Perioperative complications, such as wound infection, epidural hematoma, intraoperative dural tear, nerve root damage, and implant dislodgement, were recorded, as were the reoperations and medically related complications within 6 months. The implant-related complications, such as screw loosening, cage migration, or broken screws, detected using plain radiograph at each follow-up and CT scan at the latest follow-up were also recorded. Pedicle screw loosening was defined as a radiolucent zone around the screw on a CT scan at the 6-month follow-up

Statistical analysis was performed using SPSS (version 22.0, IBM Corp., Armonk, NY, USA). Categorical data were compared using chi-square or Fisher's exact test. Continuous data were compared using the independent t-test. The two-tailed significance level was set at p <0.05.

Study Design

Conditions

Degenerative Lumbar Spinal Stenosis

Intervention

Knight-Taylor [chairback] brace

Location

Taipei Veterans General Hospital
Taipei
Taiwan
112

Status

Completed

Source

Taipei Veterans General Hospital, Taiwan

Results (where available)

View Results

Links

Published on BioPortfolio: 2018-06-25T04:40:12-0400

Clinical Trials [2333 Associated Clinical Trials listed on BioPortfolio]

The NORDSTEN Studies/The Observational Cohort Study

The NORDSTEN- OS(Observational study) aim to study the natural course in patients with mild to moderate symptomatic lumbar spinal stenosis with and without degenerative spondylolisthesis. ...

Surgery Treatment of Degenerative One-level Stenosis of Lumbar Spine

The main method of treating degenerative stenosis of the lumbar spine is to perform decompression and fusion. Traditionally, this surgery is performed through median lumbar access. Minimal...

To Brace or Not to Brace for Single Level Lumbar Fusion Pilot

The use of a lumbar brace following single-level lumbar fusion for degenerative spondylosis (non-traumatic) is variable between surgeons. Some surgeons prefer to prescribe a brace and othe...

Pedicle Osteotomy for Stenosis Trial

This is a pivotal Randomized Clinical trial to provide clinical data to demonstrate the safety and effectiveness of the Pedicle Lengthening Osteotomy Procedure with implantation of the Alt...

Instr. vs. Non-instr. Posterolateral Spinal Fusion in Patients With Spinal Stenosis and Degenerative Listhesis

The aim of this study is to determine, in patients with grade 1 degenerative spondylolisthesis with spinal stenosis, if decompression and lumbar spinal fusion with, or without supplementar...

PubMed Articles [3111 Associated PubMed Articles listed on BioPortfolio]

Lumbar lordosis reduction and disc bulge may correlate with multifidus muscle fatty infiltration in patients with single-segment degenerative lumbar spinal stenosis.

To investigate the correlation between fatty infiltration in the multifidus muscle related to the involved nerve root and structural parameters associated with stenosis in patients with degenerative l...

Acupuncture vs Noninsertive Sham Acupuncture in Ageing Patients with Degenerative Lumbar Spinal Stenosis: A Randomized Controlled Trial.

Acupuncture is commonly used to treat degenerative lumbar spinal stenosis in Asian countries. However, rigorous data regarding the efficacy and safety of acupuncture for ageing patients is currently l...

Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking.

To understand the role of compensation mechanisms in the development and treatment of symptomatic degenerative lumbar spinal stenosis (DLSS), pelvic stability during walking should be objectively asse...

Impact of knee osteoarthritis on surgical outcomes of lumbar spinal canal stenosis.

Lumbar spinal canal stenosis (LSS) and knee osteoarthritis (KOA), both of which are age-related degenerative diseases, are independently correlated with increased pain and dysfunction of the lower ext...

Quality of life changes after lumbar decompression in patients with tandem spinal stenosis.

Tandem spinal stenosis (TSS) is a degenerative spinal condition characterized by spinal canal narrowing at 2 or more distinct spinal levels. It is an aging-related condition that is likely to increase...

Medical and Biotech [MESH] Definitions

Outgrowth of immature bony processes or bone spurs (OSTEOPHYTE) from the VERTEBRAE, reflecting the presence of degenerative disease and calcification. It commonly occurs in cervical and lumbar SPONDYLOSIS.

Tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae.

Narrowing of the spinal canal.

The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities.

A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.

More From BioPortfolio on "Is Postoperative Bracing Necessary After Spine Surgery for Degenerative Conditions"

Quick Search

Relevant Topics

Spinal Cord Disorders
The spinal cord is a bundle of nerves that runs down the middle of the back which carry signals back and forth between the body and brain. It is protected by vertebrae, which are the bone disks that make up the spine. An accident that damages the verte...

Osteoporosis
Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. Follow and track&n...

Infectious-diseases
Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...


Searches Linking to this Trial