Division of Physical Medicine and Rehabilitation, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Division of Rheumatology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Eur Spine J. 2019 Feb;28(2):442-449. doi: 10.1007/s00586-018-5837-0. Epub 2018 Nov 28.
Bracing is frequently prescribed following lumbar surgery for degenerative conditions. However, previous studies failed to demonstrate the advantage of postoperative lumbar bracing in both short- and long-term outcome in terms of pain, quality of life and fusion rate. The purpose of this study was to assess the prescription patterns and rationale for postoperative bracing amongst spinal surgeons in Belgium.
A 16-item online survey was distributed by email to spinal surgeons affiliated to the Spine Society of Belgium (N = 252).
A total of 105 surgeons (42%) completed the survey. The overall bracing frequency following lumbar surgery was 38%. A brace was more often prescribed following the fusion procedures (52%) than after the non-fusion procedures (21%) (p < 0.0001). The majority of surgeons (59%) considered bracing after at least one type of lumbar surgery. Orthopaedic surgeons (73%) reported a significantly higher rate of prescribing postoperative bracing compared to neurosurgeons (44%) (p = 0.003). Pain alleviation (67%) was the main goal for prescribing a postoperative brace. A total of 42% of the surgeons aimed to improve fusion rate by bracing after lumbar fusion procedures. A quasi-equal level of the scientific literature (29%), personal experience (35%) and teaching from peers (36%) was reported to contribute on the attitudes towards prescribing bracing.
Postoperative bracing was prescribed by Belgian spinal surgeons following more than one-third of lumbar procedures. This was underpinned by beliefs regarding pain alleviation and higher fusion rate. Interestingly, based on the scientific literature these beliefs have been demonstrated to be false. These slides can be retrieved under Electronic Supplementary Material.
对于退行性疾病的腰椎手术后，常开具支具固定。然而，先前的研究未能证明术后腰椎支具在短期和长期结果（疼痛、生活质量和融合率）方面的优势。本研究的目的是评估比利时脊柱外科医生术后支具的开具模式和开具理由。
通过电子邮件向比利时脊柱学会的脊柱外科医生（N=252）发送了一份包含 16 个项目的在线调查。
共有 105 名外科医生（42%）完成了调查。腰椎手术后支具的总体使用频率为 38%。与非融合手术（21%）相比，融合手术后更常开具支具（52%）（p<0.0001）。大多数外科医生（59%）认为至少有一种类型的腰椎手术后需要支具。与神经外科医生（44%）相比，骨科医生（73%）报告了更高的术后支具开具率（p=0.003）。缓解疼痛（67%）是开具术后支具的主要目的。共有 42%的外科医生希望通过腰椎融合术后支具来提高融合率。约有 42%的外科医生认为支具能够提高融合率。科学文献（29%）、个人经验（35%）和同行教学（36%）在一定程度上影响了他们对支具开具的态度。
比利时脊柱外科医生在超过三分之一的腰椎手术后开具了术后支具。这是基于对缓解疼痛和提高融合率的信念。有趣的是，基于科学文献，这些信念已被证明是错误的。这些幻灯片可以在电子补充材料中找到。
