I'm going to have a lumbar fusion at the L45 level. Will I need to wear a brace afterwards? What kind and for how long?
Spine surgeons (both orthopedic and neurosurgeons) often use bracing for their patients after fusion of the neck or low back. But with today's evidence-based practice, there's been a question about this practice. Is it really needed? Is there any evidence to support external immobilization of this type? Or is it just a matter of doing what we've always done because we've always done it?
A study was done in Canada to see just what are the bracing patterns of spine surgeons. They looked at bracing after both cervical spine (neck) surgeries and for lumbar spine fusions. They found that when bracing was used for the lumbar spine, it was discontinued earlier with internal fixation. Internal fixation refers to the use of metal plates, rods, and/or screws to hold the spine in place during the healing/fusion process.
As far as bracing goes, surgeons reported using a canvas-material corset for lumbar spine procedures that didn't involve fusion. Rigid bracing was used more often for fusion procedures. It didn't appear to matter whether or not a custom-made brace was used versus an off-the-shelf model.
The results of this study show there is continued reason to doubt the need for postoperative bracing after spinal fusion. There's no evidence that bracing really prevents motion of the fused vertebral segments. Likewise, there's no support for the idea that bracing slows the patient down, reduces pain, or improves the fusion rate.
It is the opinion of some surgeons that proper surgical technique and the use of rigid internal fixation to hold the spine in place should be enough. The bone will fill in and create a solid fusion without the support of an external brace. Your surgeon will guide you regarding the use of a brace after surgery. It may depend on the condition of the bone, type of surgery done, and clinical experience of the surgeon.