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. 2023 Apr;13(1_suppl):59S-72S.
doi: 10.1177/21925682221130048.

Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment

Philipp Pieroh  1 , Ulrich J A Spiegl  1 , Anna Völker  1 , Sven Märdian  2 , Nicolas H von der Höh  1 , Georg Osterhoff  1 , Christoph-E Heyde  1 ; Spine Section of the German Society for Orthopaedics and Trauma
Affiliations

Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment

Philipp Pieroh et al. Global Spine J. 2023 Apr.

Abstract

Study design: Systematic review.

Objectives: Spinal orthoses are frequently used to non-operatively treat osteoporotic vertebral fractures (OVF), despite the available evidence is rare. Previously systematic reviews were carried out, presenting controversial recommendations. The present study aimed to systematic review the recent and current literature on available evidence for the use of orthoses in OVF.

Methods: A systematic review was conducted using PubMed, Medline, EMBASE and CENTRAL databases. Identified articles including previous systematic reviews were screened and selected by three authors. The results of retrieved articles were presented in a narrative form, quality assessment was performed by two authors using scores according to the study type.

Results: Thirteen studies (n = 5 randomized controlled trials, n = 3 non- randomized controlled trials and n = 5 prospective studies without control group) and eight systematic reviews were analyzed. Studies without comparison group reported improvements in pain, function and quality of life during the follow-up. Studies comparing different types of orthoses favor non-rigid orthoses. In comparison to patients not wearing an orthosis three studies were unable to detect beneficial effects and two studies reported about a significant improvement using an orthosis. In the obtained quality assessment, three studies yielded good to excellent results. Previous reviews detected the low evidence for spinal orthoses but recommended them.

Conclusion: Based on the study quality and the affection of included studies in previous systematic reviews a general recommendation for the use of a spinal orthosis when treating OVF is not possible. Currently, no superiority for spinal orthoses in OVF treatment was found.

Keywords: conservative treatment; orthosis; osteoporosis; spine fracture; vertebral fracture.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Scheme according to PRISMA criteria and retrieved data. ** Manuscripts were excluded due to wrong treatment indication or comparison to surgery (scoliosis, comparison of non-operative to operative treatment, missing relevant outcome). Retrieved studies were additionally excluded due to missing outcome definition (n = 1), inclusion of patients ± fracture (n = 5).,,-
Figure 2.
Figure 2.
Presentation of the different follow-up visits of the included studies.
See this image and copyright information in PMC

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