Back brace vs no brace???

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Tatiyana
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Joined: 11/09/2008 - 1:55pm
Back brace vs no brace???

I am just wondering why some of us get back brace restrictions and some not. My surgeon did not even bring up the possibility of a back brace but i see others on here are told to wear them FT. Just curious...
I had an ALIF (2 weeks post op)

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Janet S. (not verified)
Title: Member
Back Brace

I wore a hard shell back brace that went from under my breast to the top of my hips full time except bed time after my surgery. It was very supportive and I did not feel comfortable without it. I had a spinal fusion at L5 S1.

HeidiG (not verified)
Title: Member
Depends on your spine, your surgery, your life, your doctor

I believe it depends on several factors, including your anatomy, your exact spine problem (some fusions are for spondys, some for herniated discs...), everything involved in your surgery (hardware type, placement, etc.), what your life is like, and your doctor's preferences.

I asked all 6 spine surgeons I met with about back braces, and they did not all agree. Some said yes, some said no way, and the surgeon I went with said he couldn't say for sure until after surgery, because it depends!

So, we talked about back brace possibilities and options before surgery. The expectation was that I would be in a softer corset type brace for about 3 months. We knew going in that I had a tough surgery ahead, and I have tricky anatomy. Also, I insisted that I wanted to maximize the chances of this working and not needing another surgery!

However, when my surgery turned out more difficult than expected (found previously unknown osteopenia & small fractures), and my hardware placement is much more "delicate" than anyone would like, I found myself in a very rigid LSO/hip-spica brace for 3-4 months (I'm at 2 months now). This makes it very difficult (but NOT impossible) for me to move in a way that could seriously compromise the fusion/hardware. It's also protective in case I were to slip (which I did, the day I left the hospital), fall down, get in a car wreck, etc.

Prior to surgery, we had talked about the possibility of this brace, but definitely did not expect it, and did not expect I might have to wear it for 4 months.

( FYI, my brace looks a lot like the one at this URL
http://www.optecbrace.com/index.asp?page_id=109 )

Bruce
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Just like with PT &

Just like with PT & exercise, surgeons vary greatly in regard to their views on back braces and as Heidi points out it also depends upon your own circumstances.

In my case (L5-S1 fusion) my surgeon was against braces as he feels that wearing a brace makes the muscles 'lazy' - he would rather have the core muscles starting to work earlier on, believing that the hardware should hold the back solid. But, that is just his view, and I know that other surgeons have different views.

Keep positive!

Bruce

...an old timer here and ex-moderator

HeidiG (not verified)
Title: Member
Keeping muscles strong

I personally think the fact that using a brace could let muscles get weak is a good reason to not use a brace too much just for pain relief (e.g., instead of or prior to surgery). Though I'm sure plenty of folks have gotten very helpful pain relief from using one!

My doctor believes that the number one priority is getting fusion (and protecting the hardware until that happens), and that muscles can be re-strengthened later--you won't get so weak or so stiff that you can't recover all that with good PT after fusion has taken. I agree with that, and think the brace is a good idea for me (especially since my hardware placement is precarious), although I do truly hate hate hate Crying wearing the brace and sometimes get annoyed at being so stiff and watching my already weak muscles get weaker.

But, that said, I HAVE been working on my core muscle strength very recently (after getting doctor's permission, and starting at the right "stage" in his recovery plan) using some simple pelvic floor and transverse abdominal contraction exercises I learned from a Pilates instructor/PT. I'm doing exercises while sitting on a ball and not stressing my spine. My therapist and I are carefully going through things to determine what is truly "safe" to do--I've learned that I simply won't do anything that either of us has any doubts about. Worried

The exercises I'm doing now are for deep core muscles and are being done in an extremely low lumbar-stress manner. But, I have to do them a lot during the day! BTW, I also did these same exercises (and others) before surgery to try to strengthen my core in advance of surgery, but at that time did them in a more aggressive manner (including lying on my back, more movement, more reps, resistance, etc.).

lsteller
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different strokes

I thought for sure I'd be in a brace. Three-level spinal fusion. Nope. Heck -- the nurses didn't even care if I got out of bed on my own the first night in the hospital. They left me no call bell, so I had no choice. I guess I have enough hardware in my back to make it unnecessary.

Linda

3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.

dilauro
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Brace or Not

As Bruce and others mentioned, there are different situations and different variables that will determine if you will need a back brace after surgery. The same applies to cervical surgeries. When I has my first lumbar surgery in 1978, besides using wooden instruments instead of today's surgical items, fusion was done for only folks that had physical jobs. Since I was a programmer and had a desk job, fusion wasnt considered. But I had to wear a back brace (almost like a corset) for 6 months.
Today, things have changed so much, so the need for back braces will depend on the individual, the surgeon and the actual surgery.

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

Angelback (not verified)
Title: Member
Not for me

Thank heavens my surgeon thinks like Bruces. He didn't want to use a brace even though it was 3 level and correction to scoliosis. He said the thinking for braces is very conservitive and he would rather me learn to use the muscles then let them waste.
To get them back to scratch later is a much bigger burden.
So I was lucky and didn't have to wear one.
Blessings Sara Angel

kathyy
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Wore brace parttime

My doc suggested I used my brace (corset style) when I went for long walks or out to the store, etc. He considered it just a little extra protection early on. After my 6 week checkup at which time I showed the beginning of fusion, he said I could ditch the brace. That made me very, very happy because I am short waisted and it was very uncomfortable.

I agree that just as we are finding out about exercising, walking and going back to work, every doc seems to be just a little different and every recovery is very different. The only thing, now, my doc is adamant about is that I use my bone growth stimulator every day for 30 minutes. Which I happen to be doing right now!!!!

Good day to all! We have a rainy day here in Georgia (wait, haven't I heard that before?) and expecting about 4 inches of rain so no walking for me Sad

kathyy
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Core exercises

What exercises have you been doing? By chance do you have workout sheet or anything you go by that you might share with me??? I'd like to start some muscle strengthening and core work, as well.

HeidiG wrote:
I personally think the fact that using a brace could let muscles get weak is a good reason to not use a brace too much just for pain relief (e.g., instead of or prior to surgery). Though I'm sure plenty of folks have gotten very helpful pain relief from using one!

My doctor believes that the number one priority is getting fusion (and protecting the hardware until that happens), and that muscles can be re-strengthened later--you won't get so weak or so stiff that you can't recover all that with good PT after fusion has taken. I agree with that, and think the brace is a good idea for me (especially since my hardware placement is precarious), although I do truly hate hate hate Crying wearing the brace and sometimes get annoyed at being so stiff and watching my already weak muscles get weaker.

But, that said, I HAVE been working on my core muscle strength very recently (after getting doctor's permission, and starting at the right "stage" in his recovery plan) using some simple pelvic floor and transverse abdominal contraction exercises I learned from a Pilates instructor/PT. I'm doing exercises while sitting on a ball and not stressing my spine. My therapist and I are carefully going through things to determine what is truly "safe" to do--I've learned that I simply won't do anything that either of us has any doubts about. Worried

The exercises I'm doing now are for deep core muscles and are being done in an extremely low lumbar-stress manner. But, I have to do them a lot during the day! BTW, I also did these same exercises (and others) before surgery to try to strengthen my core in advance of surgery, but at that time did them in a more aggressive manner (including lying on my back, more movement, more reps, resistance, etc.).

dbarbeau48
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Brace or not

My doctors believed strongly in wearing a brace after spinal fusion. They even referred to the brace (turtle shell hard brace) as a "fusion brace". I wore one specially made for me at the brace shop in the hospital off and on for about a year after my surgeries. I hated every minute of it too. The members who commented on the fact that a brace can weaken muscles were absolutely right. My core muscles to this day are still weaker than they should be.

Dick

Emergency surgery in March of 2006 for spinal infection of L 2 and L 3. During surgery, discovered I had Cauda Equina Syndrome. Spine became unstable after surgery and had 360 fusion with 10 pedicle screws, plates and rods in April of 2007.

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