Continued Use of Bracing after Instrumented Lumbar Fusion: An International Study of Practice Patterns
Bibliographic record
Abstract
OBJECTIVE: Despite guidelines advising against routine bracing after instrumented lumbar fusion, bracing remains common in clinical practice. This study aimed to evaluate global patterns of brace utilization following 1- to 2-level lumbar fusion for degenerative pathology and to assess variation by surgeon specialty and geographic region. METHODS: An international cross-sectional survey was distributed to AO Spine members. Respondents provided information regarding their bracing practices after open and minimally invasive lumbar fusion. Responses were stratified by specialty (orthopedic vs. neurosurgery) and geographic region (Asia Pacific, Europe and South Africa, Latin America, Middle East and North Africa, North America). Statistical analysis was performed using chi-square tests, with P<0.05 considered significant. RESULTS: Of 280 respondents, 253 performed 1- to 2-level lumbar fusion procedures and were included in the analysis. Bracing practices did not differ significantly based on surgeon specialty, age, gender, years in practice, fellowship training, or practice setting. However, surgeons from Asia Pacific countries reported significantly higher bracing rates following both open and MIS fusion procedures compared to other regions (P<0.001 and P=0.03, respectively). Pain control and construct protection were the most common reasons for prescribing braces. CONCLUSION: Bracing after short-segment lumbar fusion remains prevalent worldwide, with notable regional variation. These findings highlight persistent divergence from clinical guidelines and suggest a need for greater consensus and alignment in global spine care practices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".