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2013년 10월 17일 목요일

Postoperative bracing after spine surgery for degenerative conditions: a questionnaire study

Brief review


연구는 학회에 참가한 척추전문의들에게 본인의 환자에게 보조기를 사용하는 것과 관련하여 설문을 진행한 질의연구 입니다
설문의 초점 외과의들이 환자 수술 후에 사용하는 보조기의 종류, 치료기간, 사용이유 등에 관한 입니다.
응답자들이 수술을 마친 본인의 환자들에게 보조기를 사용 때에, 고정을 위한 가장 적절한 종류, 기간, 적응증에 따른 합의가 부족하다는 결론입니다.


*Title: Postoperative bracing after spine surgery for degenerative conditions
: a questionnaire study
퇴행성질환을 위한 척추수술 후의 보조기 착용: 질의 연구

*Author: Jesse E. Bible, Debdut Biswas, Peter G. Whang, Andrew K. Simpson, Glenn R. Rechtine, Jonathan N. Grauer




Background context:
-A variety of orthoses are routinely applied after spinal procedures.
-But the proper indications for postoperative bracing are not well established.

Purpose
To assess the postoperative bracing patterns of spine surgeons.

Study design/setting
Questionnaire study

Patient sample
Spine surgeons attending the “Disorders of the Spine” conference (January 2008, Whistler, Canada).

Outcome measures
Frequencies of bracing after specific surgical procedures.


Methods
Subject: spine surgeons attending the “Disorders of the Spine” conference.
Questionnaire contents: typically immobilize patients after specific spinal procedures, the type of orthosis used, the duration of treatment, the rationale for bracing.


Results
-Ninety-eight of 118 surgeons completed the survey (response rate: 83%).

1. The frequency of bracing in academic and private/ in orthopedic and neurosurgical practices
--> similar

2.The difference in the bracing tendencies of fellowship and non-fellowship trained surgeons: -----> statistically significant (61% vs. 46%, p<.0001).

3. The duration (clinical experience): no influence the propensity of surgeons to use orthoses.

4. Employed more regularly: after cervical surgery > lumbar surgery (63% vs. 49%, p<.0001).

6. In the anterior cervical spine, orthoses were used more often as the complex procedure.
(increased single -- multilevel constructs (55% vs. 76%, p<.0001) )

7. The frequencies of bracing in noninstrumented and instrumented lumbar fusions
-->not significantly different.


Conclusions
-Most of the respondents brace their patients postoperatively, there is an obvious lack of consensus regarding the most appropriate type, duration, and indications for immobilization.

-Clinical studies may play a helpful role in evaluating the efficacy of postoperative bracing protocols.