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To Brace or Not To Brace after fusion

texastigerttexastiger Posts: 48
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
My NS said "No Brace" after my 3 level lumbar fusion scheduled for June. I had a brace for my first lumbar fusion and for my cervical fusion. He believes that it will weaken the core muscles and is not necessary.

Everyone talks about their brace and I would LIKE a brace since that is my previous experience.

What does everyone think?


  • I think you probably don't have any choice in the matter unless you switch surgeons to one who believes in bracing! It has been my experience that doctors are either in one camp or the other, and one who does not believe in bracing will not make an exception for one patient.

    I have had two spine surgeons, one who always uses a brace, and the other used to brace early in his career, but no longer does. I have had lengthy discussions with each of them and each can make good arguments for his side of the issue.

    There have been recent threads on this topic. If you run a search you can read what others have said.
  • If you are not going to be wearing a brace, then it will be up to you entirely to not bend, turn, twist. etc.. Make sure you definitely have a grabber(or two). The grabber will be essential!

    Good luck!

  • Thanks Gwennie and Lisa,

    Here is one of the posts Gwennie is referring to: http://www.spine-health.com/forum/back-surgery-and-neck-surgery/back-brace-vs-no-brace

    I will just have to have more discpline in my life! LOL!
  • If you still have your old brace use it as needed after the surgery. This is one of those things that each surgeon seems to have their own way of doing . I am also surprised how many surgeons don't want PT started until very late in the healing process. Mine wanted mine started the day I got out of the hospital whereas Lynette's still isn't doing any as far as I know. We both had similar surgery's but mine was a revision and hers wasn't. I am doing what my surgeon is telling me to do. BTW I do have a brace that I wear whenever I'm out from the house. It does provide a bunch of support but I think in my case it is a precaution against getting hurt more then for support.

  • Bkins said:
    If you still have your old brace use it as needed after the surgery.
    Before you decide to use your old brace "as needed" as David suggests, please talk to your surgeon. I personally find it odd that some doctors don't want someone with a multi-level fusion to not wear a brace, but it really is each individual surgeon's choice.

    Your doctor specifically told you that you won't be wearing one, so don't undermine him by wearing one without talking to him first.

  • When you talk to your surgeon, you may just want to ask him if you can wear if a little in the bieginning when you are heavily medicated and trying to get in and out of bed.

    I found that in the first few weeks that is when I often needed mine. I knew my precautions inside and out! BUT, I didn't realize how ingrained my own habits were, in fact I didn't even realize I had habits. Especially how I got into and out of bed. My habit is to stand in front of my bed and just crawl in~I guess I have done it this way for years without really realizing it.

    Now as I am decreasing my meds, I am able to think and plan better. But, I know from my past surgeries, it is so natural/normal to twist/rotate/bend when moving laundry from washer to dryer, getting dishes out of the dishwasher and getting in and out of the car.

    Which ever way it goes, best of luck! We'll be thinking of you and keeping you in our prayers! Shari

  • Cath111 said:
    Bkins said:
    If you still have your old brace use it as needed after the surgery.

    Before you decide to use your old brace "as needed" as David suggests, please talk to your surgeon. I personally find it odd that some doctors don't want someone with a multi-level fusion to not wear a brace, but it really is each individual surgeon's choice.

    Your doctor specifically told you that you won't be wearing one, so don't undermine him by wearing one without talking to him first.

    I agree not to hide it from your surgeon.. Make sure he knows you have a older one and would feel more comfortable making use of it "as needed".

  • Couldn't agree more! If your present surgeon says no braces then do as he says.

    As has been said. Some do want it some don't. Just like the PT. Mine was started ASAP. My surgeon wanted me moving immediately. He also wanted me in a brace for 2 weeks then weaning off it over a 2 week period.

  • Thanks everyone! I guess I am stuck with what my surgeons says...I do trust him, but I remember from my first lumbar fusion that the brace gave me confidence when I would get out. Plus it is a great reminder to treat your body right. However, my old brace--which I still have--is from 1991 when I was 19 and 4 kids later, I don't think I could fit in it! :) Those were the days!!
  • I would talk to your surgeon and let him know if you would feel more comfortable in a brace. My surgeon did not give me a brace after surgery but on my first follow-up my x-rays showed the top 2 screws had moved slightly, so I was then given a brace. I can see the reasoning for both sides. While I initially hated the brace, once I got used to it, I really liked it and wished I had had it at the beginning. It really is a good reminder of no BLT's. But, as I have been weaning myself off of it, per doctor instructions, I do notice a huge difference when walking now and not wearing the brace in my stomach muscles. They feel much weaker then right after surgery.

    My PA told me my surgeon deciding bracing on an individual basis, the same with physical therapy. It's amazing how different each surgeon.

    Good luck with sugery and an uneventful and successful recovery.
  • My physican's brace guy said just to use when out of the safety of my home and to wear till he said to stop. I don't know when that will be but I go to the city friday for my 6week check up and will find out more of those details. I'm guessing until they see some fusion. I had got out my discharge instructions again and did read that they don't order PT until full fusion. I guess they all have their reasons. I'm actually glad I don't have PT yet, having the front and back incisions I think it would have been too much. Lynette
  • SpineAZSpineAZ WiscPosts: 1,084
    If you think it will help talk to the surgeon again. While he may not want to go with one of the stiff braces perhaps he'd agree to prescribing some type of brace.

    I hate my LSO brace, I admit, it. But, I also love it as I think it prevents me from doing stuff I should not do. Interestingly I don't think it affects my core muscles negatively as I still use them. I will admit that I am up a lot going to the kitchen and back and that doesn't require the brace. I also used a brace with my ACDF and that's also surgeon dependent. In each case I hated, but loved the brace.

    In 2 wseks I start weaning off the brace. When the doctor said this my hubby piped in and said "she already does that, caught her sitting at her computer without it". The surgeon asked if I was sitting up and properly and hubby said yes, so the surgeon said "great, that's fine". I guess I just made sure I'm not dependent on the brace.

    So it can't hurt to say "is there some kind of brace we can agree on?". My plan is to ask my surgeon is he can now prescribe some "permanent" brace I can use as needed. All of the off the shelf ones have helped a bit but I'd like something I can use, for example, when traveling if I feel any twinge of pain or as if something is starting up.

    Will your surgeon be prescribing a bone growth stimulator? With both my cervical and lumbar fusions one was prescribed and it helped accelerate the fusion. Not all surgeons use them right away, but if at any point the surgeon shows any concern about the rate of healing just keep this in mind as an option.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I would talk to your doctor, My surgeon doesn't believe in them, he believes you lose too much of your muscles tone. I had a friend that had a 3 lvl done by him and asked him, since I only got 1 lvl and he said, he didn't make him wear a brace either. I was surprised too, I had been on here a lot before my surgery and was expecting it and then I asked him and he was like Nope. Depends on the surgeon. What like Gretchen said, I wouldn't have minded it for remembering the BLTs, but at times its nice not to have it too. ;)
  • Yes, I will have a bone growth stimulator. It will be the first time that I will use it. Didn't have one in my last two fusions. He said I will use it 30 minutes a day. On my first lumbar fusion, I loved my brace--it was a soft one but offered lots of support. I will ask him and see, but if not, will refer to him on this one!
  • I see my doctor next week for 6 weeks check up. I was told to have my brace on whenever out of bed or in the shower. Let me tell you since I started PT last week I am sore. When I stand up and try to walk without my brace I feel like my lower back is jello...it feels so unstable. The PT said it is the muscles that are weak from being cut in surgery and not used. I will find out next week how long my surgeon wants me to wear my brace. I am weird in the fact I love my brace...lol...It makes my back feel secure and decreases pain. Prob. cause I am overweight and doesn't let my front pull on the back..:)
  • So, I asked for a soft corset. It really helped me to remember the No BLT restrictions, and just felt good to wear. Listen to your body before your doctor. Both possess intelligence.

    One Love,

  • downinmyheart said:
    Listen to your body before your doctor. Both possess intelligence.

    Very well put.

  • Good luck next week for your 6 week post op check.
    Let us know what your surgeon says. Will you hVe an x-ray to see how things are fusing?
    My appointment will be in 2 weeks time.
  • hmm, as I read this I am realizing I am not wearing my brace as much as I should be...It says to wear it when I am not in bed or the shower. I am 6 weeks post op 360.

    I did wear it when I was up initally. Now, if I get up to walk into the kitchen, or moving from one room to another, I don't wear it. If I am doing an activity, picking up the house, getting something to eat, then I wear it.

    Honestly, I don't feel a loss of muscle from the brace, but I started PT a week after surgery. Maybe that is the difference.

  • SpineAZSpineAZ WiscPosts: 1,084
    I don't wear the brace much when just around the house (making lunch, folding towels while standing, etc.) Generally anything I do that will require standing or sitting for more than 15 minutes I use the brace. I would agree that if someone wears it 24/7 and relies on it too much you could loose muscle tone.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I wore my brace religiously, all the time except sleeping and showering. I helped with my posture and was a constant reminder of the no BLT rules. I had to wean off after about six weeks, and it hurt not to have it on for a while, but it didn't take too long. I liked my brace because it had a hard shell in the back that I could take out if I just wanted a soft support.

    My muscle did indeed lose muscle tone, but it came back pretty well after about four PT sessions.

  • Hi guys,

    I just found out some info at http://www.mayoclinic.com/health/back-pain-treatment/BA99999/PAGE=BA00008

    Don't know wether or not that helps. It seems to say that intermittant use is the best.

    I really think you should be able to have one if that's your wish. I hope you find some way of finding out what's best, and I hope you recover well.

  • had my surgery 3/19 and my neuro has me wearing a hard shell brace said i need to wear it for 3 months and then will start me on p/t.yes it gets uncomfortable but i feel safer with it on.he also mentioned me wearing a soft brace after i start p/t,he knows better then i do on what is best for healing so im just gonna follow instructions,like i tell my kids you dont have to like it, just do it. lol
  • I don't have a brace. My surgeon is one of those who thinks it causes weak muscles.
    He also cleared me for driving after 10 days. Needless to say, I haven't driven yet!
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Must be very confident of his instrumentation. And maybe he dose it in a way so that a brace is not necessary. And would just weaken your muscles.
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Just goes to show each surgeon is entirely different, just like we are. My PA has already told me that when I have my next follow-up on 4/30 to see surgeon, will most likely be released for next 6 months as well as all is good on xrays, and that my surgeon generally does not have you do physical therapy, which is fine with me.

    Jelly, I'm 10 weeks out from pretty much the same surgery you had, but at L5-S1, and it looks like we had pretty much the same diagnosis, just different levels. I still have not been cleared to drive, mainly because they just started weaning me off the oxycontin at my 4/1 appointment. I did have some complications with screw movement but all looked good at 4/1 appointment.
  • Sounds like your recovery is going well now.
    I see my surgeon in 10 days for my 6 week check when he will x-ray to check that everything is in place and see if fusion has started.
    If the incision is healed and the infection gone, I'll start physiotherapy.

    Keep healing
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