Use of Orthosis (brace) or Not for Thoracolumbar Burst Fractures

Treatment for thoracolumbar burst fracture traditionally included surgery, bracing and long term bed rest. In recent years this treatment is changing because of the increased medical risks that go with long term bed rest. There has also been some interest in treating these injuries without surgery as well, again because of risks and increased costs associated with surgery. But, there haven’t been many high quality studies to determine the best course of action. Bailey et al have tried to create a study to provide information for medical professionals to reduce risks, improve outcomes and decrease costs after a thoracolumbar burst fracture.

This study compared ninety six patients who had a thoracolumbar burst fracture without any nerve damage. Forty seven patients were fitted with a thoracolumbosacral brace and forty nine were treated without any brace at all. The people with the brace used it for ten weeks. Both groups were given a lifting restriction of less than five pounds and a bending restriction not past ninety degrees at the waist for eight weeks. After this period they were encouraged to return to normal activities. Both groups were given physiotherapy during and after this first restricted period.

Results were measured after three months with a questionnaire. There was no difference between the two groups after analyzing the results of the questionnaire. This study provides evidence that there is no difference between treatment of a thoracolumbar burst fracture with a brace or without one, and that treatment without a brace is safe and effective.