Efficacy, safety and economics of bracing after spine surgery: a systematic review of the literature

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dc.contributor.author Zhu, Mary P.
dc.contributor.author Tetreault, Lindsay A.
dc.contributor.author Sorefan-Mangou, Fatimah
dc.contributor.author Garwood, Philip
dc.contributor.author Wilson, Jefferson R.
dc.date.accessioned 2018-01-31T12:53:14Z
dc.date.available 2018-01-31T12:53:14Z
dc.date.issued 2018-01-17
dc.identifier.citation Zhu, M. P., Tetreault, L. A., Sorefan-Mangou, F., Garwood, P. and Wilson, J. R. (2018) ‘Efficacy, safety and economics of bracing after spine surgery: a systematic review of the literature’, Spine Journal, 18(9), pp. 1513-1525. doi: 10.1016/j.spinee.2018.01.011. en
dc.identifier.volume 18
dc.identifier.issued 9
dc.identifier.startpage 1513
dc.identifier.endpage 1525
dc.identifier.issn 1529-9430
dc.identifier.issn 1878-1632
dc.identifier.uri http://hdl.handle.net/10468/5356
dc.identifier.doi 10.1016/j.spinee.2018.01.011
dc.description.abstract Background Context: Bracing is often used after spinal surgery to immobilize the spine, improve fusion, and relieve pain. However, controversy exists regarding the efficacy, necessity and safety of various bracing techniques in the post-surgical setting. Purpose: In this systematic review, we aimed to compare the effectiveness, safety and cost-effectiveness of postoperative bracing versus no postoperative bracing following spinal surgery in patients with several common operative spinal pathologies. Study Design/Setting: Systematic Review. Patient Sample: N/A. Outcome Measures: N/A. Methods: A systematic search was conducted of MEDLINE, Embase and the Cochrane Collaboration Library from 1970 to May 2017, supplemented by manual searching of the reference list of relevant studies and previously published reviews. Studies were included if they compared disability, quality of life, functional impairment, radiographic outcomes, cost-effectiveness and/or complications between patients treated with postoperative bracing versus those not receiving any postoperative bracing. Each article was critically appraised independently by 2 reviewers, and the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group.Results: Of the 858 retrieved citations, 5 studies met inclusion criteria and were included in this review, consisting of 4 randomized controlled trials and 1 prospective cohort study. Low to moderate evidence suggests that there are no significant differences in most measures of disability, pain, quality of life, functional impairment, radiographic outcomes, and safety between groups. Isolated studies reported statistically significant and inconsistent differences between groups with respect to Neck Disability Index at 6 weeks postoperatively and/or Short Form-36 Physical Component Score at 1.5, 3, 6, and 12 months postoperatively. Conclusions: Based on limited evidence, postoperative bracing does not result in improved outcomes following spinal surgery. Future high quality randomized trials will be required to confirm these findings. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier Inc. en
dc.relation.uri http://www.thespinejournalonline.com/article/S1529-9430(18)30014-7/abstract
dc.rights © 2018, Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Outcomes en
dc.subject Postoperative bracing en
dc.subject Surgery en
dc.subject Spinal pathology en
dc.subject Complications en
dc.title Efficacy, safety and economics of bracing after spine surgery: a systematic review of the literature en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Fatimah Sorefan-Mangou, Medicine, University College Cork, Cork, Ireland. T: +353-21-490-3000 en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2019-01-17
dc.description.version Accepted Version en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Spine Journal en


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© 2018, Elsevier Inc. All rights reserved.  This manuscript version is made available under the CC-BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2018, Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.
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