Luigi Meccariello1, Vitaliano F Muzii2, Gabriele Falzarano3, Antonio Medici3, Serafino Carta4, Mattia Fortina4, Paolo Ferrata1. 1. Department of Medicine, Surgery, and Neuroscience, Section of Orthopedics and Traumatology, "Santa Maria alle Scotte" University Hospital, University of Siena, V.le Bracci 16, 53100, Siena, Italy. 2. Department of Medicine, Surgery, and Neuroscience, Section of Neurosurgery, "Santa Maria alle Scotte" University Hospital, University of Siena, V.le Bracci 16, 53100, Siena, Italy. muzii@unisi.it. 3. Division of Orthopedics and Traumatology, "G.Rummo" Hospital, Via Pacevecchia, 53, 82100, Benevento, Italy. 4. Division of Orthopedics and Traumatology, Department of Emergency and Diagnostics, "Santa Maria alle Scotte" University Hospital, Siena University Hospital, V.le Mario Bracci 16, 53100, Siena, Italy.
Abstract
BACKGROUND: The three-point orthosis is the most commonly used brace in the conservative treatment of osteoporotic vertebral fractures. The Spinomed® dynamic orthosis represents an alternative. AIMS: We compared efficacy and safety of these two types of brace in treating osteoporotic vertebral fractures. METHODS:One hundred forty patients, aged 65-93 years, sustaining osteoporotic vertebral fracture were consecutively recruited and divided into two groups, and treated with either three-point orthosis or dynamic corset. Patients were evaluated with Visual Analogue Scale, Oswestry Low Back Pain Disability Questionnaire, and measurement of forced expiratory volume in the first second. Regional kyphosis angle, Delmas Index, and height of the fractured vertebral body were also measured on full-spine X-rays. Follow-up intervals were 1, 3, and 6 months after trauma. The complications encountered during the 6-month follow-up were recorded. RESULTS: At the 3- and 6-month follow-ups, there was a significant difference (p < 0.05) in pain, disability, and respiration in favor of the dynamic orthosis group. At 6-month follow-up, there was no significant difference (p > 0.05) in all the radiological parameters between groups. Complications were reported for 28 patients in the three-point orthosis group, and for eight patients in the dynamic corset group (p < 0.05). DISCUSSION: Biofeedback activation of back muscles is probably a key factor in improving functional outcome with dynamic orthosis. CONCLUSIONS: Compared to three-point orthosis, patients treated with dynamic orthosis had a greater reduction in pain and a greater improvement in quality of life and respiratory function, with equal effectiveness in stabilizing the fracture, and fewer complications.
RCT Entities:
BACKGROUND: The three-point orthosis is the most commonly used brace in the conservative treatment of osteoporotic vertebral fractures. The Spinomed® dynamic orthosis represents an alternative. AIMS: We compared efficacy and safety of these two types of brace in treating osteoporotic vertebral fractures. METHODS: One hundred forty patients, aged 65-93 years, sustaining osteoporotic vertebral fracture were consecutively recruited and divided into two groups, and treated with either three-point orthosis or dynamic corset. Patients were evaluated with Visual Analogue Scale, Oswestry Low Back Pain Disability Questionnaire, and measurement of forced expiratory volume in the first second. Regional kyphosis angle, Delmas Index, and height of the fractured vertebral body were also measured on full-spine X-rays. Follow-up intervals were 1, 3, and 6 months after trauma. The complications encountered during the 6-month follow-up were recorded. RESULTS: At the 3- and 6-month follow-ups, there was a significant difference (p < 0.05) in pain, disability, and respiration in favor of the dynamic orthosis group. At 6-month follow-up, there was no significant difference (p > 0.05) in all the radiological parameters between groups. Complications were reported for 28 patients in the three-point orthosis group, and for eight patients in the dynamic corset group (p < 0.05). DISCUSSION: Biofeedback activation of back muscles is probably a key factor in improving functional outcome with dynamic orthosis. CONCLUSIONS: Compared to three-point orthosis, patients treated with dynamic orthosis had a greater reduction in pain and a greater improvement in quality of life and respiratory function, with equal effectiveness in stabilizing the fracture, and fewer complications.
Authors: Eva Jacobs; Rachel Senden; Christopher McCrum; Lodewijk W van Rhijn; Kenneth Meijer; Paul C Willems Journal: Clin Interv Aging Date: 2019-04-11 Impact factor: 4.458