gms | German Medical Science

132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

Clavicle brace can significantly decrease the pain level after posterior cervical surgery

Meeting Abstract

  • Stephan Dützmann - Universitätsklinik Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Volker Seifert - Universitätsklinik Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Christian Senft - Universitätsklinik Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • John Ratliff - Stanford University, Department of Neurosurgery, Stanford, USA
  • Jon Park - Stanford University, Department of Neurosurgery, Stanford, USA

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch029

doi: 10.3205/15dgch029, urn:nbn:de:0183-15dgch0299

Published: April 24, 2015

© 2015 Dützmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Introduction: Pain after posterior cervical surgery may arise from multiple sources. Tension upon the fascia of the deep and superficial posterior cervical muscles may be one source of post-operative pain. We hypothesized that a clavicle brace could reduce the tension on the posterior fascia by approximation of the shoulders and the clavicle, which could lead to a reduction in incisional pain.

Material and methods: After IRB approval, thirty patients were prospectively randomized to receive either a clavicle brace or not after they had posterior cervical surgery. They were instructed to wear the clavicle brace day and night. The patients then recorded the average level of pain per day on a scale from 1-10 and the number of pain pills they took for the first 30 days post-op. Patients with a chronic pain condition and patients who were mentally unable to put on the brace properly were excluded from the study.

Results: Average age of the cohort was 54.7 years. There were 22 male patients. Indications for surgery were cervical myelopathy, cervical spine trauma, tumor and pseudarthrosis. Procedures were posterior cervical decompression and fusion, posterior cervical fusion and transpedicular upper thoracic tumor resection. The daily average pain level was statistically significantly reduced on post-op day 5-13 by a mean of 1.5 points (+- 0.5 points). Self reported medication use was significantly different from p.o. day 4 until p.o. day 12. 4 patients were randomized but did not tolerate wearing the brace. They dropped out of the study. One patient in the conservative group developed post-op delirium and dropped out of the study as well.

Conclusion: We conclude that wearing a clavicle brace after posterior cervical spine surgery can reduce the amount of pain and the amount of narcotic pain medication in patients that tolerate wearing the brace.