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. 2025 Mar;15(2):1318-1323.
doi: 10.1177/21925682241238672. Epub 2024 Mar 28.

Geriatric Vertebral Compression Fracture: A Database Study Characterizing Use and Trends for Prescribed Thoracic/Lumbar Orthoses

Scott J Halperin  1 , Meera M Dhodapkar  1 , Jay Moran  1 , Seongho Jeong  1 , Jonathan N Grauer  1 , Arya Varthi  1
Affiliations

Geriatric Vertebral Compression Fracture: A Database Study Characterizing Use and Trends for Prescribed Thoracic/Lumbar Orthoses

Scott J Halperin et al. Global Spine J. 2025 Mar.

Abstract

Study design: Retrospective cohort study.

Objective: Geriatric vertebral compression fractures are the most common fracture associated with osteoporosis. Using a large national database, the current study aimed to examine and characterize bracing trends for geriatric thoracic/lumbar compression fracture management.

Methods: The current study utilized the PearlDiver database from 2015-2021. Patients who suffered thoracic/lumbar compression fractures (fifth thoracic to the fifth lumbar vertebra [T5-L5]) were identified. Exclusion criteria included patients less than 65 years old or an indication of infection or neoplasm. Patients who received a brace within 90-days after the initial diagnosis of thoracic/lumbar compression fracture were abstracted and characterized overall and by fracture level. Multivariable logistic regression was performed to assess for correlation with bracing trends.

Results: In total 290 388 patients met inclusion criteria and suffered a thoracic/lumbar compression fracture (greatest incidence at the thoracolumbar junction). Of these, bracing was only prescribed for 4263 (1.5%), with the greatest variance of 1.5% by level. Independent predictors of bracing were geographic region (relative to northeast, west WE odds ratio [OR] 1.31, Midwest OR 1.20), younger age (OR 1.27 per decade), female sex (OR 1.17), and ECI (OR 1.02 per 2-point increase) (P < .05 for each).

Conclusion: Overall, the current study examined over a quarter of a million patients who suffered a T5-L5 compression fractures and found that only 1.5% of patients were braced. This low percentage, and that greatest predictor for bracing was non-clinical (geographic region), highlight the inconsistency of this practice and may be useful for developing treatment algorithms.

Keywords: bracing; epidemiology; orthosis; pearldiver; vertebral compression fracture.

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Conflict of interest statement

Declaration of Conflicting InterestsThe 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.
This figure shows the breakdown of bracing trends from 2015 through 2021. In black is the group which received a brace and in grey is the group that did not receive a brace after compression fracture.
Figure 2.
Figure 2.
This horizontal bar graph shows the frequency of compression fractures that occur at each level from T5-L5.
Figure 3.
Figure 3.
This stacked horizontal bar graph shows visually the percentage of brace (black) vs no brace (grey) by vertebral level from Table 1.
See this image and copyright information in PMC

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