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The efficacy of postoperative bracing after spine surgery for lumbar degenerative diseases: a systematic review

  • Davide NasiEmail author
  • Mauro Dobran
  • Giacomo Pavesi
Review Article

Abstract

Purpose

Postoperative bracing treatment is widely used after surgery for lumbar degenerative diseases. However, the guidelines are lacking in this regard, and its use is mainly driven by individual surgeon preferences. The objective of the current review was to evaluate the available evidence on the use of postoperative bracing after surgery for degenerative disease of the lumbar spine.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed while conducting a systematic search of the PubMed/Medline, Scopus, and Cochrane databases from January 1990 to January 2019. High-quality studies were included that evaluated disability, pain, quality of life, the rate of fusion, complications, and rate of reoperations in patients who had surgery for lumbar degenerative disease, with and without postoperative bracing. The overall strength of evidence across the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.

Results

Of the 391 citations screened, four randomized controlled trials met the inclusion criteria and were included in the review. Based on low- to moderate-quality evidence, postoperative bracing in patients with lumbar degenerative disease does not result in improved disability, pain, and quality of life compared to no bracing patients. Low-quality evidence suggests that there was no significant difference between the two groups in terms of the rate of fusion, complications, and the need for reoperation.

Conclusions

To date, there is not a medical evidence to support the use of bracing after surgery for lumbar degenerative disease.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Postoperative bracing Spine surgery for lumbar degenerative disease Lumbar spinal fusion Lumbar microdiscectomy Lumbar spine surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Supplementary material

586_2019_6202_MOESM1_ESM.pptx (284 kb)
Supplementary material 1 (PPTX 284 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neuroscience, Neurosurgery Unit, Azienda Ospedaliero-Universitaria di ModenaUniversità degli Studi di Modena e Reggio EmiliaModena, BaggiovaraItaly
  2. 2.Department of Neurosurgery, Ospedali Riuniti di AnconaUniversità Politecnica delle MarcheAnconaItaly

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