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No significant difference in fusion rates seen with postop bracing after ACDF

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SAN FRANCISCO — Although the original protocol for anterior cervical discectomy and fusion (ACDF) recommends postoperative bracing, new research indicates that this practice is unnecessary for patients undergoing one-level procedures with allograft and internal fixation.

To study the potential impact of bracing on fusion, Christian I. Fras, MD, evaluated the postoperative X-rays of 42 patients who were either prescribed postoperative bracing or received no form of external immobilization after single-level ACDF with allograft and anterior cervical plating.

Of the 17 patients who wore braces, Fras categorized 11 as fused, two as not fused and four as having indeterminate fusion. Of the 25 patients in the non-braced group, he categorized 17 as fused, three as not fused and five as having indeterminate fusion.

“This study finds no difference in the fusion rates of those who used a brace postoperatively compared to those who did not use a brace postoperatively in patients undergoing one-level anterior cervical discectomy and fusion with allograft and anterior plating,” Fras said during his presentation at the American Academy of Orthopaedic Surgeons 75th Annual Meeting. “This suggests that use of a brace is not necessary postoperatively.”

The study constitutes one of the first to examine the effect of postop bracing in patients having ACDF with allograft and plating, he added.

For more information:

• Christian I. Fras, MD, can be reached at 1991 Sproul Road, Suite 300A, Broomall, PA 19008; +1-484-427-8100.

Reference:

• Fras CI. Anterior cervical fusion: Effect of postoperative bracing. Paper #275. Presented at the American Academy of Orthopaedic Surgeons 75th Annual Meeting. March 5-9, 2008. San Francisco.