Background: Thoracolumbar fractures are common traumatic injuries that can be treated conservatively or by surgery, depending on the type and severity of the injury. This study aimed to determine the efficiency of various orthoses used for these fractures based on the available literature.
Methods: Between 1950 and 2023, a search was conducted in some databases, including PubMed Central and MEDLINE, ISI Web of Knowledge, Cochrane-centered Register of Controlled Trial (CCTR), Embase, and Scopus. Some keywords-such as conservative treatment, orthoses, brace, and cast-were used in combination with thoracolumbar fracture, burst fracture, and compressive fracture. The quality of the studies was evaluated using the PEDro scale. Two researchers independently reviewed the studies.
Results: Based on the results of the included studies, orthosis is not necessary for stable burst and compression fractures. Based on the inclusion criteria, 20 papers were selected for the final analysis, 12 of which were on the use of spinal braces and casting (with quality between 1 and 6), 2 on the no-treatment approach, and 6 on comparing the outputs of treatment with spinal braces with no braces.
Conclusion: Although the use of orthosis and cast is one of the conservative treatments recommended for patients with thoracolumbar fractures, it seems that for stable burst fractures and compression fractures, the use of a brace does not provide any benefits. However, the use of a brace or cast is recommended for burst fractures with more than 1 column fracture.
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http://dx.doi.org/10.47176/mjiri.38.62 | DOI Listing |
Cureus
December 2024
Department of Neurosurgery, Fukuoka University, Fukuoka, JPN.
Osteoporotic vertebral fractures (OVF) commonly occur at the thoracolumbar junction, and delayed neurological deficits are rare. Here, a 76-year-old female presented with low back pain and the late onset of symptoms characterized by lumbar radiculopathy. She had been suffering from lower back pain for four weeks and developed lumbar radiculopathy in the left L3 area.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Department of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
We aimed to analyze potential predictors for the development of metachronous fractures (MFs) after osteoporotic vertebral fractures (OVFs), with particular focus on radiological variables obtained at initial X-rays and computed tomography (CT) examinations, treatment applied (conservative management [CM] versus percutaneous vertebroplasty [PV]), and fractures located at the thoracolumbar junction (T11-L2). We conducted a two-center, observational retrospective study, including patients with single-level OVFs treated with CM or VP. We collected socio-demographic, radiological and treatment-related variables.
View Article and Find Full Text PDFCureus
December 2024
Orthopaedic and Spine Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, BGD.
Introduction: Ankylosing spondylitis (AS), a chronic inflammatory spondyloarthropathy affecting the spine, progressively leads to increased spinal stiffness. This condition increases the risk of spine fractures in patients, even from trivial injuries. The process of slow bone formation within the ligaments of the spine and the fusion of the spinal diarthrosis contribute to the most prominent symptom of progressive stiffness of joints, predominantly affecting the spine and sacroiliac joints.
View Article and Find Full Text PDFWorld J Psychiatry
January 2025
Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.
Background: Traumatic injuries, such as falling, car accidents, and crushing mostly cause spinal fractures in young and middle-aged people, and > 50% of them are thoracolumbar fractures. This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues, which causes paralysis of the lower limbs if there is no timely rehabilitation treatment. Young patients with thoracolumbar fractures find it difficult to recover after the operation, and they are prone to depression, low self-esteem, and other negative emotions.
View Article and Find Full Text PDFmedRxiv
January 2025
Center for Advanced Orthopedic Studies, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Pathologic vertebral fractures (PVF) are common and serious complications in patients with metastatic lesions affecting the spine. Accurate assessment of cancer patients' PVF risk is an unmet clinical need. Load-to-strength ratios (LSRs) evaluated in vivo by estimating vertebral loading from biomechanical modeling and strength from computed tomography imaging (CT) have been associated with osteoporotic vertebral fractures in older adults.
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