Evaluating the impact of brace use versus non-brace use on successful fusion rate in patients undergoing elective lumbar fusion surgery for degenerative diseases

Abstract Background: Degenerative disc disease of the lumbar spine is treated conservatively with physiotherapy, anti-inflammatory medications, and surgery for severe cases. This study aimed to investigate the effect of bracing versus non-bracing on fusion success rates in patients undergoing elective lumbar fusion surgery for degenerative diseases. This retrospective and comparative study was conducted at Shahid Kamyab and Ghaem Hospitals in Mashhad, Iran, from March 2021 to November 2024 in patients who underwent elective lumbar fusion surgery for degenerative lumbar spine disease. The case group consisted of patients who used a brace belt after surgery, whereas the control group included patients who did not use a brace belt. The fusion rate was determined using dynamic radiography and computed tomography (CT) scan data at 3, 6, and 12 months postoperatively. The Oswestry Disability Index (ODI) and general health were assessed using the Goldberg Mental Health Questionnaire (GHQ) 3 and 12 months postoperatively. Results: In this study, 400 patients were analyzed, with 200 each in the case group and 200 in the control group. The mean age of patients in the case group was 57.32 years, and in the control group, it was 56.94 years. The study found no significant differences between the case and control groups regarding gender, education, ASA class, and postoperative complications (P>0.05). Additionally, there were no significant differences in patient fusion rates at 3-, 6-, 9-, and 12-months post-surgery as well as in ODI, leg pain, back pain, and GHQ scores before surgery and at 3- and 12-months post-surgery (P>0.05). The mean return to work (RTW) time showed no significant difference between the two groups (P>0.05), and Kaplan-Meier survival analysis of RTW rates at 12 months post-intervention indicated consistent rates in both groups (P=0.602, 95% CI: 0.817-1.223). Conclusion: The study found that brace use after lumbar fusion surgery for degenerative diseases did not improve patient outcomes. There were no significant differences in disability, pain, quality of life, fusion rates, or complication rates between the patients who used a brace and those who did not. Further research is required to establish clear guidelines for postoperative care.