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Will I have a brace after surgery? Why do I need one? When do I need to wear it?

Sometimes a brace is needed after surgery, depending on the instrumentation used and the surgeon’s confidence in the fusion’s security. If you are given a brace, obviously you should follow the surgeon’s directions as to when and how to wear it, but usually you will need to wear it whenever you are out of bed. This includes sitting. It is unusual to have to sleep in it.

There are different styles of braces, depending on your specific needs, but mine was a thin plastic contraption that closed with Velcro straps. It fit fairly well under my jeans, but I found it useful to have my shirts one size larger than I normally wear. Click here for photos of my post-op brace.

I know it can be miserable, and can be a low blow to go through the whole surgery experience, to think you’re done, and then to have it not really be over for another three months or so until you can throw the brace away, but it is really, really important to wear the brace if they tell you to. The surgeon will only give you one if he feels you need it. If you need one and don’t wear it, you run the risk of seriously damaging your back and having to have surgery all over again. Trust me, even three months in a hot brace is easier than repeating surgery.

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How can I make my brace as comfortable as possible?

Lotion and Wipes

To help alleviate the dry, flaky skin that often occurs under the brace, try an in-shower lotion, such as Olay Moisturinse In-Shower Body Lotion for Extra Dry Skin. Bath and Body Works also makes an in-shower lotion now. Traditional lotions are no match for “brace skin.”

Baby wipes are very nice for periodically wiping under the brace during the day. It can get pretty hot in there. Any brand of baby wipe will do, but try for the ones with aloe vera. Your skin will appreciate it.

Lining, Padding and Undershirts

My brace was unlined in back, so I found it painful to lay down or sit against a chair back with the brace on because it pushed on my very tender spine, so my mom sewed some cloth liners for the inside of my brace, with extra padding in the upper back area. We made four, so that I could have one for the day and one for the night, and only have to do laundry every other day. After a few weeks, I only needed them at night, and eventually didn’t need them at all. I realized later that the same thing could probably have been accomplished by sewing extra padding to the back side of a cloth undershirt. Oh well, live and learn.

Wear a cotton undershirt under the brace. Make sure there are no wrinkles! It is convenient to get the kind of undershirt with a built-in bra, so you have one less layer to manage.

  • I tried several kinds, but found that a simple spaghetti strap 95% cotton, 5% spandex kind worked best. They had a built-in bra and covered my back enough that they were comfortable. They were also long enough that they didn’t ride up. (If your undershirts ride up, your stomach sticks to the brace and it feels gross.)
  • Getting the undershirts one size smaller than you would normally wear will help prevent wrinkles.
  • Avoid undershirts with a “racer back” style if your brace comes up your back at all. This style of undershirt does not cover the skin on your back enough, and you will stick to the brace, which hurts.

An egg-crate foam pad on my mattress made sleeping more comfortable. Bed Bath and Beyond has these pads for about $15. They also have a number of other styles, although those are more expensive.

Fitting

The brace should fit properly. You shouldn’t get pressure sores or redness, so report any to your doctor and/or bracemaker. (By the way, a bracemaker is called an orthotist.) At the same time, the brace should fit pretty snuggly. It should move everywhere you do, with no "jiggle" or looseness. It will take some getting used to, but eventually you adjust.

Keeping Cool

I know it sounds weird, but if you take cloth scrunchies (like you put around your ponytails), spray them with just a bit of water, and put them in the freezer, they make very nice bracelets. The inside of your wrist has a lot of blood vessels, so putting something cold on there will help cool you off. It also works if you take a baby’s water-filled teething ring, refrigerate it, and wear it as a bracelet. (If you want something less fashionable, you can wrap an ice cube in a washcloth and hold it against the inside of your wrist, and/or drape a wet washcloth around the back of your neck.)

Clothes

You will probably need clothes one size larger to fit comfortably over the brace. It is most convenient if the waist is elastic and shirts are loose. You will probably find that you wear clothes out faster because of the velcro and/or metal parts of the brace.

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