TY - JOUR T1 - Short-Term Impact of Bracing in Multi-Level Posterior Lumbar Spinal Fusion JF - International Journal of Spine Surgery JO - Int J Spine Surg SP - 915 LP - 920 DO - 10.14444/8119 VL - 15 IS - 5 AU - Ryan Dimentberg AU - Saurabh Sinha AU - Gregory Glauser AU - Ian F. Caplan AU - James M. Schuster AU - Scott D. McClintock AU - Jang W. Yoon AU - Paul J. Marcotte AU - Zarina S. Ali AU - Neil R. Malhotra Y1 - 2021/10/01 UR - http://ijssurgery.com//content/15/5/915.abstract N2 - Background: Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs.Methods: Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013–2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days.Results: Amongst the study population, 936 were braced and 44 were not braced. There was no difference between the braced and unbraced cohorts regarding LOS (P = .106), discharge disposition (P = .898), 30-day readmission (P = .434), and 30-day ED evaluation (P = 1.000). There was also no difference in total cost (P = .230) or QALY gain (P = .740). The results indicate a significantly lower likelihood of SSI in the braced population (1.50% versus 6.82%, odds ratio = 0.208, 95% confidence interval = 0.057–0.751, P = .037). There was no difference in relevant comorbidities (P = .259–1.000), although the braced cohort was older than the unbraced cohort (63 versus 56 y, P = .003).Conclusion: Bracing following multilevel posterior lumbar fixation does not alter short-term postoperative course or reduce the risk for early adverse events. Cost analysis show no difference in direct costs between the 2 treatment approaches. Short-term data suggest that removal of bracing from the postoperative regimen for PLF will not result in increased adverse outcomes. ER -