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Review
. 2024 Apr 16;19(4):e0297541.
doi: 10.1371/journal.pone.0297541. eCollection 2024.

Post-operative bracing following adult spine deformity surgery: Results from the AO Spine surveillance of post-operative management of patients with adult spine deformity

So Kato  1 , Justin S Smith  2 , Devin Driesman  3 , Christopher I Shaffrey  4 , Lawrence G Lenke  5 , Stephen J Lewis  3 ; AO Spine Knowledge Forum Deformity
Affiliations
Review

Post-operative bracing following adult spine deformity surgery: Results from the AO Spine surveillance of post-operative management of patients with adult spine deformity

So Kato et al. PLoS One. .

Abstract

Study design: Cross-sectional international survey with a literature review.

Objectives: While some surgeons favor spine bracing after surgery for adult spine deformity (ASD) to help prevent mechanical failures, there is a lack of evidence. The objective of the present study was to better understand the current trend in the use of bracing following ASD surgery based on an international survey.

Methods: An e-mail-based online survey was conducted among over 6000 international AO Spine members regarding the post-operative management of patients with ASD. The details of brace prescription, indications and influencing factors were solicited. Descriptive data were summarized based on different demographic groups and fusion levels for the responding surgeons who annually perform at least 10 long-segment fusions of >5 levels extending to the pelvis.

Results: A total of 116 responses were received, including 71 surgeons (61%) who used post-operative bracing for >5 levels of long fusion. The most common reason for bracing was pain management (55%) and bone quality was the strongest influencing factor (69%). Asia-Pacific surgeons had the highest rate of bracing (88%), while North American surgeons had the lowest (45%). The most common type of brace used were TLSO for cases with an uppermost instrumented vertebra (UIV) in the low- or mid-thoracic spine and a cervical brace for UIV at T1-3. The majority (56%) used bracing for 6-12 weeks after surgery.

Conclusions: The present survey demonstrated significant interest in bracing following ASD surgery, however, there is substantial variability in post-operative bracing practice. A formal study on the role of bracing in ASD surgery is needed.

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Conflict of interest statement

SK receives grants from Baxter and Olympus Terumo Biomaterials. JSS receives grants from DePuy Synthes/ISSG and AO Spine, royalties from Zimmer Biomet and NuVasive, consulting fees from Zimmer Biomet, NuVasive, SeaSpine, Cerapedics, and Carlsmed, has leadership roles in ISSG, and has stock or stock options for Alphatec, Nuvasive and Carlsmed. DD has no declarations. CIS receives grants from NIH and ISSG, royalties from NuVasive, Medtronic, and SI-Bone, consulting fees from Proprio, Medtronic, and SI-Bone, and has stock or stock options for Priprio and NuVasive. LGL receives grants from Scoliosis Research Society, Setting Scoliosis Straight Foundation, AO Spine NIH and ISSG, royalties from Medtronic and Acuity Surgical, consulting fees from Medtronic and Acuity Surgical. SJL has no declarations. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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