Brace treatment for compression fractures may not provide additional improvement in healing, mobility or pain

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A study published in Journal of Bone & Joint Surgery found that patients who wore a brace as treatment for a spinal compression fracture had comparable outcomes in terms of pain, function and healing when compared to patients who did not wear a brace.

The study, led by Ho-Joong Kim, orthopaedic surgeon and assistant professor, Seoul National University College of Medicine was undertaken as the efficacy of brace application for the treatment of esteoporotic compression fractures remains unclear. According to Kim, although braces theoretically provide stability to the fracture site, they “do have some potential disadvantages, including muscular atrophy, deconditioning, skin irritation, additional costs and delays in rehabilitation while waiting for brace application.”

In the study, 60 patients (age 65 and older) with acute osteoporotic compression fractures were randomly assigned within three days of injury to wear a soft brace, a rigid brace or no brace. Outcomes then were measured at 12 weeks using Oswestry Disability Index (ODI) and Visual Analogue Pain Scale (VAS) scoring.

The mean adjusted ODI scores in the no brace and soft brace groups were 35.95 and 37.83, respectively.  Similarly, the mean adjusted ODI score in the no brace and rigid brace groups were 35.95 and 33.54, respectively. In addition:

  • The overall ODI and VAS scores that measure lower back pain (p=0.292) and anterior body compression ratios (p=0.237) did not differ significantly among the groups after 12 weeks;
  • The ODI and VAS scores for back pain significantly improved with time after the fractures (p<0.001), and the body compression ratios significantly decreased with time in all three groups;
  • There was no difference in the compression ratio, as seen on radiographic image, general health status and patient satisfaction rates among the three groups;
  • Short Form 36 (SF-36) health survey scores decreased at 12 weeks (p=0.716) following compression fractures in all groups, confirming previous study findings which found a decrease in life quality following a compression fracture;
  • There was no significant difference (p=0.912) in opioid use between the three groups at 12 weeks.

“In addition to the cost and discomfort associated with braces, the findings in this study suggest that brace treatment for osteoporotic compression fractures may not provide any additional improvement in fracture healing, mobility and pain,” concludes Kim.