No evidence for the effectiveness of bracing in patients with thoracolumbar fractures
- PMID: 19404808
- PMCID: PMC2823176
- DOI: 10.3109/17453670902875245
No evidence for the effectiveness of bracing in patients with thoracolumbar fractures
Abstract
Background and purpose: The use of braces is widespread in patients with thoracolumbar fractures. The effectiveness of bracing, however, is controversial. We sought evidence for the effect of bracing in patients with traumatic thoracolumbar fractures based on outcome and length of hospital stay (LOS). Furthermore, we evaluated the incidence of complications of bracing.
Methods: An electronic search strategy with extensive MeSH headings was used in various databases to identify studies that compared bracing and non-bracing therapies. Two reviewers independently selected systematic reviews, randomized controlled trials (RCTs), controlled clinical trials, and observational studies, and both assessed the methodological quality and extracted the data.
Results: No systematic reviews or RCTs were found. 7 retrospective studies were included. None of these studies showed an effect of bracing. Because of poor methodological quality, no best-evidence synthesis could be performed. One observational study was selected in which a complication of bracing was reported.
Interpretation: In the present literature, there is no evidence for the effectiveness of bracing in patients with traumatic thoracolumbar fractures. The lack of high-quality studies prevents relevant conclusions from being drawn.
Similar articles
-
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma: Nonoperative Care.Neurosurgery. 2019 Jan 1;84(1):E46-E49. doi: 10.1093/neuros/nyy369. Neurosurgery. 2019. PMID: 30203096
-
Functional outcome of thoracolumbar burst fractures managed with hyperextension casting or bracing and early mobilization.Spine (Phila Pa 1976). 1996 Sep 15;21(18):2170-5. doi: 10.1097/00007632-199609150-00022. Spine (Phila Pa 1976). 1996. PMID: 8893445
-
Effects of Bracing on Clinical and Radiographic Outcomes Following Thoracolumbar Burst Fractures in Neurologically Intact Patients: A Meta-Analysis of Randomized Controlled Trials.JBJS Rev. 2019 Sep;7(9):e9. doi: 10.2106/JBJS.RVW.19.00006. JBJS Rev. 2019. PMID: 31567716
-
A pilot evaluation of the role of bracing in stable thoracolumbar burst fractures without neurological deficit.J Spinal Disord Tech. 2014 Oct;27(7):370-5. doi: 10.1097/BSD.0b013e31826eacae. J Spinal Disord Tech. 2014. PMID: 22907065 Clinical Trial.
-
Orthosis in Thoracolumbar Fractures: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Spine (Phila Pa 1976). 2020 Nov 15;45(22):E1523-E1531. doi: 10.1097/BRS.0000000000003655. Spine (Phila Pa 1976). 2020. PMID: 32858744
Cited by
-
Thoracolumbar spine trauma: Evaluation and surgical decision-making.J Craniovertebr Junction Spine. 2013 Jan;4(1):3-9. doi: 10.4103/0974-8237.121616. J Craniovertebr Junction Spine. 2013. PMID: 24381449 Free PMC article. Review.
-
Reducing Radiation and Lowering Costs With a Standardized Care Pathway for Nonoperative Thoracolumbar Fractures.Global Spine J. 2019 Dec;9(8):813-819. doi: 10.1177/2192568219831687. Epub 2019 Mar 5. Global Spine J. 2019. PMID: 31819846 Free PMC article.
-
Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study.J Clin Med. 2019 Feb 6;8(2):198. doi: 10.3390/jcm8020198. J Clin Med. 2019. PMID: 30736328 Free PMC article.
-
Thoracolumbar fractures without neurological impairment: A review of diagnosis and treatment.EFORT Open Rev. 2017 Mar 13;1(9):332-338. doi: 10.1302/2058-5241.1.000029. eCollection 2016 Sep. EFORT Open Rev. 2017. PMID: 28507775 Free PMC article. Review.
-
Management of thoracolumbar spine trauma: An overview.Indian J Orthop. 2015 Jan-Feb;49(1):72-82. doi: 10.4103/0019-5413.143914. Indian J Orthop. 2015. PMID: 25593358 Free PMC article.
References
-
- Axelsson P, Johnsson R, Stromqvist B. Effect of lumbar orthosis on intervertebral mobility. A roentgen stereophotogrammetric analysis. Spine. 1992;17:678–81. - PubMed
-
- Bakker FC, Segers MJM, Patka P. Operative treatment of thoracolumbar spinal fractures. Ned tijdschrift traum. 2002;5:123–32.
-
- Benzel EC, Larson SJ. Postoperative stabilization of the posttraumatic thoracic and lumbar spine: a review of concepts and orthotic techniques. J Spinal Disord. 1989;2:47–51. - PubMed
-
- Blamoutier A, Milaire M, Garreaude LC, Lassale B, Deburge A. Cotrel-Dubousset instrumentation in the treatment of thoracolumbar and lumbar spine fractures. Rev Chir Orthop Reparatrice Appar Mot. 1992;78:529–35. - PubMed
-
- Blauth M, Bastian L, Knop C, Lange U, Tusch G. Inter-observer reliability in the classification of thoraco-lumbar spinal injuries. Orthopade. 1999;28:662–81. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical