Rückenorthesen in der Behandlung von Wirbelkörperfrakturen bei Osteoporose

Abstract

This literature search concerning the potential role of spinal orthoses for rehabilitation and treatment of atraumatic vertebral fractures between Th4 and L5 with osteoporosis and without any evidence for a secondary cause, provided no evidence for the benefits of traditional rigid thoracolumbar corsets, which only had a poor compliance. In addition, there are indications that these rigid corsets may even worsen the disease condition especially in the long-term. Wearing these corsets can result in further loss of muscle mass and strength followed by loss of bone and bone mass. Both together can worsen the functional capabilities of patients. On the other hand the functional capabilities of patients suffering from acute or subacute vertebral fractures due to osteoporosis can be improved by flexible backpack orthoses. These spinal orthoses generate an extension moment about the spine, increase perception of one's own body posture via biofeedback and therefore lead to improved posture. This results in a strengthening of the trunk musculature, a more stable equilibrium and a reduction of pain, which are associated with an increase in functional capabilities and improvement in the parameters of the quality of life. During a long-term phase of rehabilitation individually tailored spinal orthoses guarantee a high level of compliance and adherence. Finally, there is high-quality evidence that spinal orthoses with additional weighting can improve the equilibrium in women with vertebral osteoporosis and hyperkyphosis. Future studies should also be carried out with other groups of patients.

Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment

“…Despite five 5,7-10 reviews detected the low evidence for the use of orthoses in the treatment of OVF, their use was recommended. Two studies determined inconclusive evidence for orthotic use and therefore no recommendation was given.…”

“…31,32 Three studies analyzed the effects of orthoses independent of their type on biomechanics, pain, QoL. [7][8][9][10] Besides of bracing Goodwin et al investigated the effects of taping and Hofler and Jones included studies with a crossover design and operatively treated patients. 6,12 Included articles in previous reviews, in the present review and excluded articles are summarized for each review in Table 4.…”

“…12 Five studies did not mention the reason for the repetition of the systematic review. 5,[9][10][11][12] Three authors repeated the review because they detected missing clear recommendations, included further studies or performed statistical analyses. [6][7][8] Six previous reviews used RoB, [5][6][7][8][9]12 two the GRADE approach, 7,11 and two a meta-analysis 7,11 and one study did not perform a qualitative analysis.…”

“…[5][6][7][8][9][10][11] But methodical aspects of the included studies were not fully evaluated possibly resulting in controversial recommendations. [5][6][7][8][9][10][11][12] Additionally, several aspects like the type of diagnostics used, fracture region, number of fractures, orthosis treatment (daily treatment and duration) were sparsely reported. Although several reviews highlight the low quality of included studies, their recommendations are based on them.…”

Osteoporose – Diagnostik und Therapie

“…Die Anwendung von Reklinationsorthesen führt zu einer Besserung der Schmerzen und Aufrichtung der Kyphose. Der Kyphosewinkel kann reduziert und die Muskulatur gekräftigt werden [11]. Dabei haben die sog.…”