Why not brace after surgery?

[golfnut]

Does anyone know the reason that some surgeons don't have you wear a brace following surgery????

I don't think Dr. Lenke usually requires one, but when I've been practicing the logroll getting out of bed and when I toss and turn all night, I keep thinking that it would be easy to accidentally twist. I'll ask Dr. Lenke in Nov. at my pre-op, but I can't think of a reason for not wearing a brace. I'm sure he has his reasons. I would gladly wear one if it would prevent me from doing damage following surgery. I asked one other time and no one seemed to know the answer, so I'm trying, again. Thanks!

[Back-out]

Great question! I've been wondering the same thing forever (well, since the surgery started seeming real). I was hoping I'd have a surgeon who insisted on a brace. And yes, though there are other reasons, the night-time damage possibility was uppermost.

In this connection I'll note two real-life examples.

1) AFAIR JenM's neck problem began sometime after surgery after she reports having slept on it badly.

2) I noticed a few months ago that I was occasionally doing weird things to my left thumb in my sleep. This was important because I had a very delicate operation on it in January (basal joint was reconstructed using tendon graft). To protect it, I resumed using the custom splint .

It sure caught my attention though, looking forward to the much more extensive surgery on my spine. I don't even know how many times I was doing hijinks to my thumb joint, as it only occasionally woke me with pain (but I noticed it was aching the next day and I seem to have permanently lost some dexterity).

Yep, how indeed can we prevent ourselves from doing damage to our fragile spines after surgery? We could be dreaming anything and act it out a little or a lot. This is more likely to happen when we're in pain and our sleep is disturbed because of it. For that matter, going on and off pain medications changes a lot. Withdrawal can produce nightmares. Tossing and turning are more common. When I'm utterly exhausted and finally sleep, that sleep is abnormal.

We could even fall out of bed! I haven't done that in a LONG time (I guess we train ourselves to stop short sometime in infancy), but it does happen once every few years. The consequences after surgery would be catastrophic.

Why then, aren't BED-RAILS required too? I think I'm going to try to arrange for a bed that has them (I see they're available on line).

One of the only questions I did get to ask my last consult was about braces, and no - he only uses corsets. I see this as a drawback! (Don't even know if I could put it on alone).

[leahdragonfly]

Hi Amanda,

I think the answer to your question is that the instrumentation that is used is so rigid and secure that a brace is not necessary in many cases.

For complicated, long fusions and revisions, I think the brace is used to protect against bending-twisting-lifting, as a reminder. Also I have read it helps support the muscles at first and keep the person more comfortable because it rests the muscles. As far as I know the post-op braces are not worn in bed. I doubt you can harm your instrumentation during sleep.



Gayle

[LindaRacine]

Does anyone know the reason that some surgeons don't have you wear a brace following surgery????

I don't think Dr. Lenke usually requires one, but when I've been practicing the logroll getting out of bed and when I toss and turn all night, I keep thinking that it would be easy to accidentally twist. I'll ask Dr. Lenke in Nov. at my pre-op, but I can't think of a reason for not wearing a brace. I'm sure he has his reasons. I would gladly wear one if it would prevent me from doing damage following surgery. I asked one other time and no one seemed to know the answer, so I'm trying, again. Thanks!

Hi...

If you want to wear a brace 24/7, I suspect that could be arranged. ;-)

I can tell you that after surgery, your nighttime movements will be far less active than they are now. Everything changes. I can't remember ever hearing that someone's movements during sleep caused a problem with the implants.

Many surgeons have stopped bracing because they feel it causes atrophy to the core muscles. The newer implant systems are so secure in the hands of a really skilled surgeon that the amount of movement to dislodge anything is beyond what a normal postop patient would even attempt. Also, some of these surgeons are using a brace for just a few months,

I think it's really rare that a surgeon tells a patient to wear a brace 24/7.

Regards,
Linda

[Pooka1]

The newer implant systems are so secure in the hands of a really skilled surgeon that the amount of movement to dislodge anything is beyond what a normal postop patient would even attempt.

Yep. I think the only reason adults are braced post op is because of Ti Ed threatening to ski through powder up to his neck.

[golfnut]

Linda,

That makes total sense about the core muscles atrophying if one relied totally on a brace instead of tightening the abs. I guess it surprised me that some surgeons still brace following surgery while others don't. Naturally, I'd rather not wear a brace unless it's necessary.
Thanks for your answer.

[Susie*Bee]

I was one who wore a brace-- for 5 months. My understanding is that my surgeon does not brace very many of his patients, but I was told I might be a candidate and to bring some men's white t-shirts with sleeves that fit snugly with me to the hospital, to wear underneath a brace, just in case-- snugly, so there wouldn't be wrinkles to irritate my skin. My fusion was a long one, and there were other procedures, I have arthritis, etc., and he must have felt I just needed the extra support. The brace was molded for me there in the hospital, probably about day 5, after some of the swelling had gone down. It was adjusted later on a little too, as it was rubbing under my armpits a little also.

Yes, your muscles do atrophy-- and it is very hard when you stop wearing the brace. You can't stop "cold turkey"-- but have to wean off. By the end of each time period, your back just aches from holding itself up! It took me a month. There are different types of braces. We had a show and tell thread awhile back-- I'll try to attach a link. It actually was a thread about a lot of questions on an upcoming surgery, but part was about bracing. Posts #9 and #11 show pictures of two types of braces. #11 is mine, and shows the glorious "boob cut-outs" I had... http://www.scoliosis.org/forum/showt...8&page=1&pp=15

I wore mine when I was "up"-- standing, sitting, etc. It came off when I was sleeping or showering. When I was sleeping, I was always on my back, and believe me, there was no thrashing about or rolling over in my sleep. Things change with your surgery. I had always been a tummy sleeper and have never done so since. I don't miss it.

[titaniumed]

Sharon

It wasn’t the powder skiing... It was the horizontal bungee jumping that changed brace protocol....

Next time your teenager is sleeping late, tell them that this just crossed my mind. LOL

http://www.youtube.com/watch?v=z8bVx43qlHo

Ed

[Pooka1]

Ti Ed, that is crazy!!! Doesn't look safe!

[titaniumed]

Karen

The one thing that surgeons are worried about is a sudden impact like a fall. Falling down or a car accident would exert forces not acceptable in the immediate weeks after surgery.

I only wore mine when leaving the house in the car for the first 2 months.

Best to fit after surgery, mine had to be refitted since I grew 4 inches, and was 9 months along from my ileus.

Here is a picture, this sums it up. The smoke is from constipation.
Ed

[Pooka1]

Karen

The one thing that surgeons are worried about is a sudden impact like a fall. Falling down or a car accident would exert forces not acceptable in the immediate weeks after surgery.

I only wore mine when leaving the house in the car for the first 2 months.

Best to fit after surgery, mine had to be refitted since I grew 4 inches, and was 9 months along from my ileus.

Here is a picture, this sums it up. The smoke is from constipation.
Ed

Excellent.

[Susie*Bee]

Thanks for the comic relief, Ed, as always... I tend to plod along and answer and forget to lighten up. BTW-- did you get that heart you wanted? Or is that in yet another surgery???? You are such a cool guy, yet you look SO "HOT" in that pic! Take care!

[Pooka1]

Thanks for the comic relief, Ed, as always... I tend to plod along and answer and forget to lighten up. BTW-- did you get that heart you wanted? Or is that in yet another surgery???? You are such a cool guy, yet you look SO HOT in that pic! Take care!

Ti Ed once remarked that his house is such a cool contemporary that once a woman enters, she never wants to leave! I wonder where he houses all those women!!

[titaniumed]

I use the inlaw quarters, where else?

[Pooka1]

i use the inlaw quarters, where else?

lol!!!!!!!!!!!