The Impact of Postoperative Lumbar Bracing on Patient-Reported Outcomes in Short-Segment Lumbar Fusion.
Publication/Presentation Date
12-1-2025
Abstract
BACKGROUND: The efficacy and indications of postoperative bracing devices following lumbar fusion remain controversial among spine surgeons. This study aims to assess the effect of bracing patient-reported outcome measures (PROMs) following short-segment lumbar fusion surgeries.
METHODS: A retrospective analysis of patients from a single tertiary referral care center who underwent 1-2 level posterior lumbar decompression and fusion or transforaminal lumbar interbody fusion with or without bracing between 2015 and 2020 was performed. Patient demographics, surgical characteristics, 2-year revision rates, and PROMs were collected. PROMs were collected at baseline and at 3, 6, and 12 months postoperatively. Collected PROMs include visual analog scale (VAS) for back/leg pain, Oswestry Disability Index, and the Short Form Health Survey (SF-12) Physical Component Scores and Mental Component Scores (MCS) 12.
RESULTS: A total of 170 patients were identified (87 brace, 83 patients no brace). There was no significant difference between braced and nonbraced cohorts in 2-year revision rates for pseudoarthrosis (1.1% vs. 1.2%, P = 1.000) or 90-day readmissions (1.1% vs. 1.2%, P = 1.000). On bivariate analysis, there were no significant differences in postoperative Oswestry Disability Index, VAS-Back, VAS-Leg, or Physical Component Score 12 scores at any time point. Patients treated with bracing demonstrated a significantly higher 1-year MCS-12 score (52 vs. 48, P = 0.032). On multivariate regression, bracing did not independently predict change in any PROM at 3 or 6 months. At 1 year, bracing predicted improved MCS-12 scores (β = 5.1, P = 0.044).
CONCLUSIONS: Postoperative bracing following 1-2 level posterior lumbar decompression and fusion and transforaminal lumbar interbody fusion surgery did not improve PROMs for pain, disability, and physical function. The isolated improvement in MCS-12 1 year postoperatively may represent a chance finding or a potential psychosomatic comfort but might not justify the physical and financial burden of bracing in this patient population.
Volume
204
First Page
124568
Last Page
124568
ISSN
1878-8769
Published In/Presented At
Dalton, J., Olson, J., Green, W. A., Ng, M., Narayanan, R., Baek, G., Lee, Y., Mathew, J., Opara, O. A., Fano, A., Kohring, A., Lee, Y., Patrizio, H. A., Carey, P., Kirkpatrick, Q., Miranda, J., Kurd, M. F., Mangan, J. J., Canseco, J. A., Hilibrand, A. S., … Schroeder, G. D. (2025). The Impact of Postoperative Lumbar Bracing on Patient-Reported Outcomes in Short-Segment Lumbar Fusion. World neurosurgery, 204, 124568. https://doi.org/10.1016/j.wneu.2025.124568
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41115610
Department(s)
Administration and Leadership
Document Type
Article