Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study.

Tsuyoshi Kato,Hirotaka Haro,Ukihide Tateishi,Shoichi Ichimura,Toshitaka Yoshii,Masato Yuasa,Takashi Hirai,Takashi Tsuji,Yasuaki Tokuhashi,Daisuke Togawa,Koji Otani,Suketaka Momoshima,Makoto Tomita,Yutaka Sasao,Hiroaki Nakamura,Masahiko Takahata,Atsushi Okawa,Ryuichi Takemasa,Tetsuro Ohba,Hiroyuki Inose,Kengo Sato ,Tôru Hirano ,Minoru Hoshino

doi:10.3390/jcm8020198

Abstract

While bracing is the standard conservative treatment for acute osteoporotic compression fracture, the efficacy of different brace treatments has not been extensively studied. We aimed to clarify and compare the preventive effect of the different brace treatments on the deformity of the vertebral body and other clinical results in this patient cohort. This multicenter nationwide prospective randomized study included female patients aged 65–85 years with acute one-level osteoporotic compression fractures. We assigned patients within four weeks of injury to either a rigid-brace treatment or a soft-brace treatment. The main outcome measure was the anterior vertebral body compression percentage at 48 weeks. Secondary outcome measures included scores on the European Quality of Life-5 Dimensions (EQ-5D), visual analog scale (VAS) for lower back pain, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). A total of 141 patients were assigned to the rigid-brace group, whereas 143 patients were assigned to the soft-brace group. There were no statistically significant differences in the primary outcome and secondary outcome measures between groups. In conclusion, among patients with fresh vertebral compression fractures, the 12-week rigid-brace treatment did not result in a statistically greater prevention of spinal deformity, better quality of life, or lesser back pain than soft-brace.

Highlights

Owing to the aging population, the prevalence of osteoporosis has increased rapidly, and the number of patients with fragile fractures has increased
The diagnosis of compression fracture was based on the presence of acute lower back pain and the findings present in their plain lateral radiograph or magnetic resonance imaging (MRI)
A total of 141 patients were assigned to the rigid-brace group, whereas 1J. 4C3lin.pMaetdi.e2n01t9s, 8w, 19e8re assigned to the soft-brace group (Figure 2)

Summary

Introduction

Owing to the aging population, the prevalence of osteoporosis has increased rapidly, and the number of patients with fragile fractures has increased. Changes in anterior vertebral height caused by osteoporotic vertebral compression fractures can progress with time and result in spinal deformities, such as degenerative kyphosis [3]. Hyper kyphotic alignment itself imposes stress on the anterior spinal column, increases the risk of new compression fractures, and disrupts normal body balance, resulting in an increased risk of falls and other fractures [3]. When treating osteoporotic vertebral compression fracture patients, reducing the degree of spinal deformity as much as possible is important for improved QOL after fracture

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