Is postoperative bracing after pedicle screw fixation of spine fractures necessary? Study protocol of the ORNOT study: a randomised controlled multicentre trial

Smits, Arjen J.; Deunk, Jaap; Stadhouder, Agnita; Altena, Mark; Kempen, Diederik H.R.; Bloemers, Frank W.

doi:10.1136/bmjopen-2017-019596

Cited by 5 publications

(6 citation statements)

References 44 publications

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“…Two prospective reports dealt with postoperative bracing including 119 patients. No indication for postoperative bracing regarding pain relief or quality of life was observed [22,23]. The same was true for 96 patients with conservatively treated thoracolumbar burst fractures [9] or following single-level lumbar discectomy in 54 patients [20].…”

Section: Discussionmentioning

confidence: 88%

“…The orthosis must be clearly defined in terms and function (Table 1). Only when a differentiated cause of the complaint according to "specific diagnosis" was determined (group A) and the appropriately adapted "diagnosis based orthosis" was used (group C), were positive effects found in prospective studies ( [2,5,9,22,28,30], Table 1), one retrospective study ( [28], Table 1) and one review article ([10], Table 2).…”

Section: Overview Of the Current Literaturementioning

confidence: 99%

“…Wordings were non-specific with regard to low back pain, back pain, etc. [6,8,14,[17][18][19]22,27,28]. Within meta-analyses, review articles and an online survey, the causes of the pain were not differentiated [10,12,15,16,24,26,29].…”

Section: Summary Of the Literature And Whether It Supports The Indication Of Spinal Orthosis Treatment In Low Back Painmentioning

confidence: 99%

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An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

Landauer

Trieb

2022

JCM

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Background: The current literature is not conclusive for spinal orthosis treatment in low back pain. Therefore, two questions have to be answered: Does the current literature support the indication of spinal orthosis treatment in low back pain? Which treatment concept can be derived from the result? Method: The 30 highest-rated literature citations (PubMed: best match, 30 December 2021) dealing with low back pain and spine orthosis were included in the study. Excluded were all articles related to Kinesio Taping, scoliosis, physical exercise, or dealing with side effects and unrelated to treatment effect. Thus, the literature list refers only to “low back pain and spine orthoses”. These articles were analyzed according to the PRISMA criteria and divided according to “specific diagnosis”, when the cause of pain was explained (group A), or when “specific diagnosis is not given” (group B). The articles were also distinguished by the information about the orthosis. Articles with biomechanical information about the function of the orthoses were called “diagnosis-based orthosis” (group C). All other articles were part of the group “unspecific orthotic treatment” (group D). The results were compared to each other in terms of effectiveness. According to anatomical causes, a concept of orthosis selection depending on diagnosis of low back pain for clinical practice was developed. The risk of bias lies in the choice of the MESH terms. The synthesis of the results was a clinical treatment concept based on findings from the current literature. Results: The literature citations with 1749 patients and 2160 citations of literature were processed; 21 prospective clinical or biomechanical studies and 9 review articles were included. The combination of literature citations according to “specific diagnosis” (group A) and “diagnosis based orthosis” (group C) was very likely to lead to a therapeutic effect (seven articles). No positive effect could be found in four articles, all dealing with postoperative treatment. When “specific diagnosis is not given” (group B) and combined with “unspecific orthotic treatment” (group D), therapy remained without measurable effect (15 articles). An effect was described in four articles (three biomechanical studies and one postoperative study). In review articles, according to specific diagnosis, only one article dealt with fractures and another with stenosis. In all review articles where specific diagnosis was not given, no effect with spine orthoses could be found. Using this knowledge, we created a clinical treatment concept. The structure was based on diagnosis and standardized orthoses. According to pain location and pathology (muscle, intervertebral disc, bone, statics, postoperative) the orthoses were classified to anatomical extent and the mechanical limitation (bandage, bodice, corset, orthosis with shoulder straps and erecting orthosis). Conclusion: The effectiveness of spinal orthoses could not be deduced from the current literature. The most serious limitation was the inconsistency of the complaint and the imprecise designation of the orthoses. Interpretation: Articles with a precise allocation of the complaint and a description of the orthosis showed a positive effect. The treatment concept presented here is intended to provide a basis for answering the question concerning the effectiveness of spinal orthoses as an accompanying treatment option in low back pain.

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Section: Discussionmentioning

confidence: 88%

Section: Overview Of the Current Literaturementioning

confidence: 99%

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An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

Landauer

Trieb

2022

JCM

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“…[21][22][23] Moreover, it also preserves the integrity of posterior spinal muscle-ligament complexes, and less damage the biomechanical stability of the spine. 24,25 Because of the small incision and the assistance of the working channel, minimally invasive percutaneous internal fixation has less damage to the soft tissues, reduces the stimulation and interference to the nerves and blood vessels, and avoids denervated muscle atrophy.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy and imaging observation of three surgical approaches in treatment of Thoracolumbar Fractures

Li¹,

Liu²,

Ma³

et al. 2023

Pak J Med Sci

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Objective: To observe the efficacy and imaging of surgical treatment of thoracolumbar fractures via the paravertebral muscle space approach. Methods: A retrospective analysis was conducted on patients with thoracolumbar fractures receiving surgery in Baoding First Central Hospital from January 2019 to December 2020. According to different surgical approaches, they were divided into paravertebral approach group, posterior median approach group and minimally invasive percutaneous approach group. They received surgery via the paravertebral muscle space approach, posterior median approach and minimally invasive percutaneous approach, respectively. Results: Statistically significant differences were found in surgical duration, intraoperative bleeding volume, intraoperative fluoroscopy frequency, postoperative drainage volume and hospital stay among the three groups. One year after surgery, the VAS, ADL and JOA scores of the paravertebral approach group and the minimally invasive percutaneous approach group had statistically significant differences from the posterior median approach group (P < 0.05). Conclusion: For the surgical treatment of thoracolumbar fractures, the clinical efficacy of the paravertebral muscle space approach is superior to that of the traditional posterior median approach, and the clinical efficacy of the minimally invasive percutaneous approach is similar to that of the posterior median approach. All the three approaches can effectively improve the postoperative function and pain symptoms of patients without increasing the incidence of complications. Compared with the posterior median approach, the surgery via the paravertebral muscle space and minimally invasive percutaneous approaches presents shorter surgical duration, less bleeding and shorter hospital stay, which is more conducive to postoperative recovery of patients. doi: https://doi.org/10.12669/pjms.39.3.3295 How to cite this: Li H, Liu X, Ma W, Wang S. Clinical efficacy and imaging observation of three surgical approaches in treatment of Thoracolumbar Fractures. Pak J Med Sci. 2023;39(3):902-907. doi: https://doi.org/10.12669/pjms.39.3.3295 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Таким образом, период до активизации пациентов резко сокращается -они садятся и встают уже в 1-е сутки после операции, интенсивность болевого синдрома значительно ниже в связи с малоинвазив-ностью и низкой травматичностью доступа. Период реабилитации также становится короче, многие пациенты через 4-6 нед возвращаются к повседневной жизни [6].…”

Section: малоинвазивные методы хирургического леченияunclassified

Surgical treatment of spine injuries

Aganesov

Kheilo

Aleksanyan

et al. 2018

Khir. Z. im. N.I. Pirogova

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Is postoperative bracing after pedicle screw fixation of spine fractures necessary? Study protocol of the ORNOT study: a randomised controlled multicentre trial

Cited by 5 publications

References 44 publications

An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

Clinical efficacy and imaging observation of three surgical approaches in treatment of Thoracolumbar Fractures

Surgical treatment of spine injuries

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