Bracing of thoracic and lumbar spine fractures

Abstract

SummaryA prospective study of the non-operative management of 33 thoracic and lumbar fractures and dislocations was undertaken examining factors such as duration of bed rest and brace prescription. Outcome was assessed using Frankel's grading system and serial radiological examination.Bed rest for 6 to 8 weeks followed by 16 weeks of immobilisation in a thoraco lumbar orthosis (either a moulded plastazote lined polythene brace or a Taylor brace) resulted in less than 15�' kyphus in 8500 of patients and less than 20° () kyphus in 9400, One patient with a T12/L1 dislocation who had an early decom pressive laminectomy showed persistent instability and required internal fixation.One patient with an L1 fracture who initially wore a Hexalite brace developed late instability (at 12 months after injury) and required spinal osteotomy and fusion.Neurological improvement was observed in 50° () of patients, and no permanent neurological deterioration occurred.A non-operative regimen of treatment of fractured thoracic and lumbar vertebrae as described is an alternative to prolonged immobilisation in bed, or early operative fusion.

The Role of Orthosis in Spinal Injury

“…From a historical standpoint, there are probably not many Goldthwaithe frames available, but previously this frame was an option for applying a body jacket with the spine in a hyperextended position. Jones et al [11] in 1987 conducted a prospective study of 33 thoracic and lumbar fractures utilizing a TLSO after 6-8 weeks of bed rest. The levels ranged from T 3 to L 3 .…”

The Role of Spinal Orthoses in Osteoporotic Vertebral Fractures of the Elderly Population (Age 60 Years or Older): Systematic Review

“…The type of orthosis studied and further characteristics are summarized in Table 3. 20 Jacobs et al, 201 9 21 Li et al, 201 5 22 Valentin et al, 201 3 23 Vogt et al, 200 8 24 Dionyssiotis et al, van Leeuwen et al, 200 0 29 Jones et al, 198 7 30 Alin et al, 201 9 31 Stadhouder et al, 200 9 32 Chiba et al, 201 1 33 Review article Ameis et al, 201 8 34 Muratore et al, 201 8 35 Rajasekaran et al, 201 7 36 Goodwin et al, 201 6 37 Jin et al, 201 6 38 McCarthy et al, 201 6 39 Newman et al, 201 6 40 Karimi et al, 201 5 41 Rzewuska et al, 201 5 42 Chang et al, 201 4 43 Longo et al, 201 1 44 Lin…”

The effects of orthosis on thoracolumbar fracture healing: A review of the literature

“…Various parameters have been used to represent the severity of fracture and also the effects of orthosis including: neurological status, canal compromise, ability to return to work, severity of pain, kyphosis angulations, complication, rate of remodeling, narrowing, vertebral height reduction and vertebral alignment. 5,7,8,10,12,13,[16][17][18][19][20][21][22] …”