Effect of Brace to Osteoporotic Vertebral Fracture: a Meta-Analysis

Jin, Yuan; Lee, Jae Hyup

doi:10.3346/jkms.2016.31.10.1641

Cited by 42 publications

(39 citation statements)

References 19 publications

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“…In a meta-analysis, the effect of treatment of orthoses has been investigated on back pain and the kyphosis angle in rehabilitation after an acute or sub-acute vertebral fracture. The results showed that treatment with the activating spinal orthosis after a sub-acute vertebral fracture significantly improved back pain and the kyphosis angle but the overall quality of the results was rated as low [ 39 ]. This may indicate that the kyphosis angle may be affected in a sub-acute stage, but it will be more difficult at a later stage.…”

Section: Discussionmentioning

confidence: 99%

Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial

et al. 2019

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SummaryThe treatment effect of an activating spinal orthosis on back pain and back extensor strength was compared to a training group and to a control group. Between the groups, there was no significant difference in back pain, back extensor strength, or kyphosis index after the 6 months of treatment.PurposeThe aim of this study was to study the effect of treatment with an activating spinal orthosis on back pain, back extensor strength, and kyphotic index. Our hypothesis was that an activating spinal orthosis may be an alternative treatment to decrease back pain and increase back extensor strength.MethodsA total of 113 women aged ≥ 60 years with back pain and osteoporosis, with or without vertebral fractures, were randomized to three groups: a spinal orthosis group, an equipment training group, and a control group. All three groups were examined at baseline and followed up after 3 and 6 months. Statistical analyses were performed with a mixed model for repeated measures according to intention to treat (ITT) and per protocol (PP).ResultsA total of 96 women completed the study. Between the groups, there was no significant difference in baseline characteristics. Comparison between groups showed no significant difference in back pain, back extensor strength, or kyphosis index at the follow-up after 6 months according to ITT and PP analyses. Analysis in each group showed that the back extensor strength had increased by 26.9% in the spinal orthosis group, by 22.1% in the exercise training group and by 9.9% in the control group.ConclusionsSix months’ treatment by an activating spinal orthosis showed no significant difference in back pain, back extensor strength, or kyphosis index between the three groups. In the spinal orthosis group, present back pain decreased slightly and back extensor strength increased by 26.9% which indicates that the spinal orthosis may become an alternative training method.Clinicaltrials.com ID: NCT03263585Electronic supplementary materialThe online version of this article (10.1007/s11657-018-0555-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial

et al. 2019

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“…Consequently, this has led to previous meta-analyses, in the general rather than elderly population, of equivocal nature without clear recommendations concerning their use. 37,38,40 It has been previously posited that immobilization with orthoses leads to muscle atrophy and is therefore paradoxically detrimental to vertebral healing and posture. Indeed, one survey demonstrated that a similar belief was held by up to 50% of clinicians.…”

Section: Discussionmentioning

confidence: 99%

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

Kweh

Lee

Tan

et al. 2020

Global Spine Journal

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Study Design: Systematic review. Objective: Spinal orthoses have been generally used in the management of osteoporotic vertebral fractures in the elderly population with purported positive biomechanical and functional effects. To our knowledge, this is the first systematic review of the literature examining the role of spinal orthoses in osteoporotic elderly patients who sustain low energy trauma vertebral fractures. Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Methodical searches utilizing MEDLINE, EMBASE, Google Scholar, and Cochrane Databases was performed. Results: Of the 2019 articles initially retrieved, 7 published articles (4 randomized controlled trials and 3 prospective cohort studies) satisfied the inclusion criteria. Five studies reported improvement in quantitative measurements of spinal column stability when either a rigid or semirigid orthosis was used, while 1 study was equivocal. The studies also showed the translation of biomechanical benefit into significant functional improvement as manifested by improved postural stability and reduced body sway. Subjective improvement in pain scores and quality of life was also noted with bracing. Conclusion: The use of spinal orthoses in neurologically intact elderly patients aged 60 years and older with osteoporotic compression vertebral fractures results in improved biomechanical vertebral stability, reduced kyphotic deformity, enhanced postural stability, greater muscular strength and superior functional outcomes.

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“…The start of non-surgical treatment for stable OSF usually consists of initial bed rest, analgesia, early physiotherapy, early rehabilitation, and a rigid spinal brace (orthosis). Pain related to the OSF may last up to 4 months [ 16 ]. Spinal braces are usually applied for a minimum of 3 weeks and up to 12 months, depending on the patient’s symptoms and the fracture healing progress [ 17 , 18 , 19 , 20 ].…”

Section: Passive Spine Braces In the Treatment Of Osteoporotic Spimentioning

confidence: 99%

“…A recent meta-analysis looking at the effect of a brace on OSF concluded that a Spino-med orthosis, which work with a concept of improving the strength of users’ trunk muscle, unlike traditional rigid braces which offer immobilization of the spine, may subsequently reduce pain, reduce kyphosis angle deterioration, and improve quality of life [ 16 ]. However, due to the high risk of bias in the blinding process and outcome assessment in the included studies, only low-quality evidence proved using Spino-med braces could bring large and significant beneficial effect to patients with subacute osteoporotic vertebral fractures [ 18 ].…”

Section: Passive Spine Braces In the Treatment Of Osteoporotic Spimentioning

confidence: 99%

Review of Current Spinal Robotic Orthoses

Mak

Accoto

2021

Healthcare

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Osteoporotic spine fractures (OSF) are common sequelae of osteoporosis. OSF are directly correlated with increasing age and incidence of osteoporosis. OSF are treated conservatively or surgically. Associated acute pain, chronic disabilities, and progressive deformities are well documented. Conservative measures include a combination of initial bed rest, analgesia, early physiotherapy, and a spinal brace (orthosis), with the aim for early rehabilitation to prevent complications of immobile state. Spinal bracing is commonly used for symptomatic management of OSF. While traditional spinal braces aim to maintain the neutral spinal alignment and reduce the axial loading on the fractured vertebrae, they are well known for complications including discomfort with reduced compliance, atrophy of paraspinal muscles, and restriction of chest expansion leading to chest infections. Exoskeletons have been developed to passively assist and actively augment human movements with different types of actuators. Flexible, versatile spinal exoskeletons are designed to better support the spine. As new technologies enable the development of motorized wearable exoskeletons, several types have been introduced into the medical field application. We have provided a thorough review of the current spinal robotic technologies in this paper. The shortcomings in the current spinal exoskeletons were identified. Their limitations on the use for patients with OSF with potential improvement strategies were discussed. With our current knowledge of spinal orthosis for conservatively managed OSF, a semi-rigid backpack style thoracolumbar spinal robotic orthosis will reduce spinal bone stress and improve back muscle support. This will lead to back pain reduction, improved posture, and overall mobility. Early mobilization is an important part of management of patients with OSF as it reduces the chance of developing complications related to their immobile state for patients with OSF, which will be helpful for their recovery.

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Effect of Brace to Osteoporotic Vertebral Fracture: a Meta-Analysis

Cited by 42 publications

References 19 publications

Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial

Effect of treatment on back pain and back extensor strength with a spinal orthosis in older women with osteoporosis: a randomized controlled trial

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

Review of Current Spinal Robotic Orthoses

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