Conservative management of patients with an osteoporotic vertebral fracture

Abstract

Osteoporotic vertebral compression fractures (VCFs) are an increasing public health problem. Recently, randomised controlled trials on the use of kyphoplasty and vertebroplasty in the treatment of these fractures have been published, but no definitive conclusions have been reached on the role of these interventions. The major problem encountered when trying to perform a meta-analysis of the available studies for the use of cementoplasty in patients with a VCF is that conservative management has not been standardised. Forms of conservative treatment commonly used in these patients include bed rest, analgesic medication, physiotherapy and bracing. In this review, we report the best evidence available on the conservative care of patients with osteoporotic VCFs and associated back pain, focusing on the role of the most commonly used spinal orthoses. Although orthoses are used for the management of these patients, to date, there has been only one randomised controlled trial published evaluating their value. Until the best conservative management for patients with VCFs is defined and standardised, no conclusions can be drawn on the superiority or otherwise of cementoplasty techniques over conservative management.

Acute and chronic pain in vertebral fractures as systemic osteoporosis complication. Literature review

“…Длительность постельного режима при переломе тела позвонка на фоне остеопороза должна быть минимальной (не более 2-3 дней) и без ограни-чений, т.е. больным разрешается вставать в корсете на крат-ковременный срок [15,16]. Купирование боли в этот период кроме того достигается использованием короткого курса пероральных или инъекционных форм нестероидных про-тивовоспалительных препаратов (НПВП), миорелаксантов центрального действия [17].…”

Bracing for thoracolumbar fractures

“…Unfortunately, none of the randomized studies that evaluated the use of vertebroplasty or kyphoplasty used any standardization in the nonsurgical treatment arms, 16,41 a limitation reflected in a recent review by Longo et al 20 The American Association of Orthopedic Surgeons Guidelines for Treatment of Osteoporotic Spinal Compression Fractures were unable to recommend for or against bracing in patients with osteoporotic compression fractures.…”

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

“…[1][2][3] Various treatment methods have been used to manage thoracolumbar fracture. [4][5][6][7] The main goals of treatment are to provide stability, to relieve pain, to restore function, and to reduce the deformities such as kyphosis or lordosis associated with spinal fracture. [4][5][6][7] Various conservative treatments have been recommended including postural re-education, bed rest, body cast, and use of orthoses.…”

“…Currently, bracing is a fundamental part of conservative treatment for thoracolumbar fracture even after surgery. 6 Most common orthoses for vertebral fracture include the 3-point hyper extension (Jeweet style), Boston overlap orthosis (BO), and Taylor style. 4,8 Orthoses help to stabilize fractured vertebra, to relieve pain and to reduce intradiscal pressure.…”

“…14 Moreover, it was defined that early mobilizations in a total contact TLSO produce satisfactory functional results. Although the goals of using an orthosis are to provide support, rest, immobilization, protection, correction and remainder, 6 it is controversial whether the use of orthosis has the aforementioned benefits for thoracolumbar fractures or not. Therefore, the aim of this review was to determine the effect of using various orthoses in the treatment of vertebral fracture.…”