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  • Brace

    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?
    I am stronger than scoliosis, and won't let it rule my life!
    45 years old - diagnosed at age 7
    A/P surgery on March 5/7, 2013 - UCSF

  • #2
    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.
    Melissa

    Fused from C2 - sacrum 7/2011

    April 21, 2020- another broken rod surgery

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    • #3
      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.
      Surgery March 3, 2009 at almost 58, now 63.
      Dr. Askin, Brisbane, Australia
      T4-Pelvis, Posterior only
      Osteotomies and Laminectomies
      Was 68 degrees, now 22 and pain free

      Comment


      • #4
        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.
        age 48
        80* thoracolumbar; 40* thoracic
        Reduced to ~16* thoracolumbar; ~0* thoracic
        Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
        Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
        Not "confused" anymore, but don't know how to change my username.

        Comment


        • #5
          Originally posted by JenniferG View Post
          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 :-)
          I am stronger than scoliosis, and won't let it rule my life!
          45 years old - diagnosed at age 7
          A/P surgery on March 5/7, 2013 - UCSF

          Comment


          • #6
            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!
            T10-pelvis fusion 12/08
            C5,6,7 fusion 9/10
            T2--T10 fusion 2/11
            C 4-5 fusion 11/14
            Right scapulectomy 6/15
            Right pectoralis major muscle transfer to scapula
            To replace the action of Serratus Anterior muscle 3/16
            Broken neck 9/28/2018
            Emergency surgery posterior fusion C4- T3
            Repeated 11/2018 because rods pulled apart added T2 fusion
            Removal of partial right thoracic hardware 1/2020
            Removal and replacement of C4-T10 hardware with C7 and T 1
            Osteotomy

            Comment


            • #7
              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.
              Karen

              Surgery-Jan. 5, 2011-Dr. Lenke
              Fusion T-4-sacrum-2 cages/5 osteotomies
              70 degree thoracolumbar corrected to 25
              Rib Hump-GONE!
              Age-60 at the time of surgery
              Now 66
              Avid Golfer & Tap Dancer
              Retired Kdgn. Teacher

              See photobucket link for:
              Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
              Before and After Picture of back 1/7/11
              tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
              http://s1119.photobucket.com/albums/k630/pottoff2/

              Comment


              • #8
                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.
                Congenital Scoliosis and Kyphosis
                Diagnosis at Age 42, Main Thoracolumbar curve 72 deg
                Surgery on Aug 15, 2012
                Fused T4 to L4, 2 SPOs

                Comment


                • #9
                  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
                  Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                  ---------------------------------------------------------------------------------------------------------------------------------------------------
                  Surgery 2/10/93 A/P fusion T4-L3
                  Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                  Comment


                  • #10
                    I actually feel that the brace makes me feel better when I am wearing it. The pain is less when I have it on
                    Melissa

                    Fused from C2 - sacrum 7/2011

                    April 21, 2020- another broken rod surgery

                    Comment


                    • #11
                      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.
                      Be happy!
                      We don't know what tomorrow brings,
                      but we are alive today!

                      Comment


                      • #12
                        Originally posted by rohrer01 View Post
                        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
                        Melissa

                        Fused from C2 - sacrum 7/2011

                        April 21, 2020- another broken rod surgery

                        Comment


                        • #13
                          Originally posted by rohrer01 View Post
                          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
                          Diagnosed at age 12 with a double major curve

                          Braced till age 15

                          SSBOB T12-L2 Anterior age 34. (October 22,2012) Dr. Robert Gaines Jr. ( Columbia, MO)

                          Revision Surgery T2-Sacrum with Pelvic Fixation Prosterior age 35 (November 13,2013) Dr. Michael Kelly (St. Louis, MO)

                          Revision Surgery L4/L5 due to BMP Complication age 36 (November 20,2014) Dr. Michael Kelly (St. Louis, Mo)

                          Revision Surgery due to broken rod scheduled for October 19, 2016 with Dr. Michael Kelly (St. Louis, MO)

                          Comment


                          • #14
                            Originally posted by rohrer01 View Post
                            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.
                            I am stronger than scoliosis, and won't let it rule my life!
                            45 years old - diagnosed at age 7
                            A/P surgery on March 5/7, 2013 - UCSF

                            Comment


                            • #15
                              Originally posted by rohrer01 View Post
                              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
                              Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                              2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                              2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                              2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                              2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                              2018: Removal L4,5 screw
                              2021: Removal T1 screw & rod

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