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Irina
06-16-2013, 07:15 PM
I am curious why some doctors prescribe the brace after the surgery and others don’t. I understand the pros of the brace – to prevent us from making any wrong moves, like twisting, and protect in case of falling. What is the logic behind for not prescribe a brace – to have back muscles working?

mabeckoff
06-16-2013, 07:28 PM
I have had a brace for every one of my back/neck surgeries. I really like having a brace. The negative is when you want to wean off the brace, you have to build up your muscles.

JenniferG
06-16-2013, 07:36 PM
I'd be interested in the answer to this question. I wasn't required to wear a brace after surgery T4 to S1 with pelvic fixation. I wonder if the pelvic fixation means the construct is more stable and a brace isn't required? Anyone with pelvic fixation, required to wear a brace? Interesting.

Confusedmom
06-16-2013, 08:40 PM
I asked Dr. Lenke's nurse this question. She said Dr. Lenke's thinking is that the internal hardware is strong enough that a brace is usually not needed. (It serves as an internal brace.) But he does use them occasionally, like I think recently with Linda's revision.

I will say that muscles still atrophy, even without wearing a brace, just from not using your back the same way.

Truth be told, I wish I had worn a brace. I think it would have reassured me that I wasn't messing something up.

Irina
06-16-2013, 08:58 PM
I'd be interested in the answer to this question. I wasn't required to wear a brace after surgery T4 to S1 with pelvic fixation. I wonder if the pelvic fixation means the construct is more stable and a brace isn't required? Anyone with pelvic fixation, required to wear a brace? Interesting.

I have a pelvic fixation and was required to wear a brace. Now I only wear it while driving and grocery shopping. Comes handy because cashiers see my brace and always offer help out :-)

jackieg412
06-17-2013, 04:06 PM
I wonder if it isn't what the doctor wants to do. Since some do and some don't. I had a brace for 1st surgery--t10-pelvis. Dr said it was to remind me not to twist. Since I fractured through t-9 right after surgery--I hurt the spine any way. Second surgery t2-t10 no brace .Dr said only brace he could have used was a halo--I am glad he didn't!

golfnut
06-17-2013, 07:42 PM
I had asked this same question on the forum before my surgery (which was 2 1/2 years ago)when I was told that I wouldn't have to wear a brace and knew that so many on the forum were required to wear one. Dr. Lenke's nurse told me that he prefers that we use muscles rather than relying on the brace. I was afraid that I would forget and bend or twist too much, however, I thought about my back every waking moment during the recovery period so it was not a problem. I also did not roll over for probably a year when sleeping. I just got used to sleeping on my back from the very beginning. I am glad I didn't have to wear a brace, however, if it prevents one from breaking a rod when falling, it would be worth the discomfort.

rajma
06-17-2013, 08:24 PM
i wore a brace for 4 months after surgery. I think it was just a protective measure. Mine was external made of Aluminum.
Wore it anytime I got out of bed. I think they prescribe it for patients who need some additional support for the fusion. Mine was probably because I had three missing pedicles on the left. I also read that it is used in revision cases.
Weaning off the brace was very hard for the first few weeks. Like everyone said, the risk of atrophy needs to be traded off vs risk of something going wrong with the fusion.

LindaRacine
06-18-2013, 01:13 AM
Hi...

I think it's really just an MD preference, and usually has nothing to do with what levels have been fused. Of the five surgeon with whom I work, for long instrumented fusions, 2 surgeons prescribe only soft braces and aren't at all strict about making patients wear them, 2 surgeons use off the shelf hard braces, and 1 surgeon uses custom made hard braces. I think the doctors who still use hard braces, do so because they're covered by insurance, and it gives them an extra layer of protection during the early stages of fusion. And, I think the doctors who don't typically use hard braces, think that the implants are so secure that the braces don't really add enough to justify the cost.

The one thing I can tell you for certain is that no one really knows if postop braces are effective.

--Linda

mabeckoff
06-18-2013, 03:56 PM
I actually feel that the brace makes me feel better when I am wearing it. The pain is less when I have it on

rohrer01
06-18-2013, 04:44 PM
Just out of curiosity, how tight are these braces? Do they put them on you right away? I ask because I would think that a tightly worn brace over a new surgical site could cause infection. Wounds need to be kept clean and dry, something sweat is not.

mabeckoff
06-18-2013, 05:00 PM
Just out of curiosity, how tight are these braces? Do they put them on you right away? I ask because I would think that a tightly worn brace over a new surgical site could cause infection. Wounds need to be kept clean and dry, something sweat is not.

I get them a few days after surgery. I always wear a cotton tshirt under it and there is always a dressing on the incision

tae_tap
06-18-2013, 05:59 PM
Just out of curiosity, how tight are these braces? Do they put them on you right away? I ask because I would think that a tightly worn brace over a new surgical site could cause infection. Wounds need to be kept clean and dry, something sweat is not.

I had a corset fitted prior to surgery and had a short fusion. They had me wearing it once out of ICU when I was up, but over a shirt. It actually felt good having it snug at first.

Tamena

Irina
06-18-2013, 09:48 PM
Just out of curiosity, how tight are these braces? Do they put them on you right away? I ask because I would think that a tightly worn brace over a new surgical site could cause infection. Wounds need to be kept clean and dry, something sweat is not.

I got my brace several days after the surgery, in fact, close to a discharge date because my stomach was so swollen that I looked like 6 months pregnant. They waited for my belly to go down with not much luck and fitted me for the brace as I was. So, after my stomach became more normal (and hematoma issue was addressed), my brace was not tight at all. It sits securely though because of the velcro strips and I wear a t-shirt underneath.

susancook
06-20-2013, 04:12 AM
Just out of curiosity, how tight are these braces? Do they put them on you right away? I ask because I would think that a tightly worn brace over a new surgical site could cause infection. Wounds need to be kept clean and dry, something sweat is not.

My brace is like Irina's. it has Velcro, so it can pull as tight as you like. The plastic does not cover the incision in the back as it is slightly open there. I wear a tee shirt underneath which gets really sweaty. I actually like my brace as it gives me a feeling of security.

Mine was fitted on day 4 after my surgery as you need to be able to stand for ten minutes while they make a plaster cast of your body that is the pattern for the mold. They returned in 2 days with my brace.

Susan

rohrer01
06-20-2013, 11:05 AM
My brace is like Irina's. it has Velcro, so it can pull as tight as you like. The plastic does not cover the incision in the back as it is slightly open there. I wear a tee shirt underneath which gets really sweaty. I actually like my brace as it gives me a feeling of security.

Mine was fitted on day 4 after my surgery as you need to be able to stand for ten minutes while they make a plaster cast of your body that is the pattern for the mold. They returned in 2 days with my brace.

Susan

That seems to make a lot of sense. I know they used to put people in full body braces as standard procedure way back when... Open in the back for ventilation is a great idea. Bracing is probably a moot point for me even IF I have surgery as they will have to fuse into my lower neck. The only thing that would work in that case would be a halo. They didn't even have a corrective brace for me as a teen that would reach the curve otherwise I would probably have had to wear one. Not even the Milwaukee brace would touch my curve. I heard them debating about it in front of me! But, with that said, I can see how nice it would be to have that sense of security, yet miserable at the same time. I hope weaning off of it isn't too difficult. Thanks for sharing.

Irina
06-20-2013, 12:29 PM
I hope weaning off of it isn't too difficult. Thanks for sharing.

rohrer01,

Weaning off the brace is not that difficult at all, at least for me. At my last follow up appointment Dr. Hu said that I can take off the brace for as long as tolerated. My immediate response was: "What if I can tolerate to never wear this brace again?" and she told me to go for it. She advised though that my back will get tired and suggested to wear my brace on my walks outside of the house. Yes, my back gets a little tired, but I am so overwhelmed by being around people and looking NORMAL that I don't even pay attention to that little sense of tiredness.

rohrer01
06-20-2013, 12:54 PM
Irina,
Thanks for sharing, also. I get that very tired feeling and haven't had surgery. I guess I never imagined that a person would get it after surgery since the hardware is doing the work instead of the muscles. I was expecting that pain would increase without a brace both for post surgical and for kids with braces. I learn a lot here. Even if it's not relevant to me, I have a grandchild and future grandchildren that I need to be informed for. Hopefully all of this "knowledge" will be for naught in the case of my grandchildren.