Article
Clavicle brace can significantly decrease the pain level after posterior cervical surgery
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Published: | April 24, 2015 |
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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.