Dynamic corset versus three-point brace in the treatment of osteoporotic compression fractures of the thoracic and lumbar spine: a prospective, comparative study

Background The three-point orthosis is the most commonly used brace in the conservative treatment of osteoporotic vertebral fractures. The Spinomed (R) dynamic orthosis represents an alternative. Aims We compared efficacy and safety of these two types of brace in treating osteoporotic vertebral fractures. Methods One hundred forty patients, aged 65-93 years, sustaining osteoporotic vertebral fracture were consecutively recruited and divided into two groups, and treated with either three-point orthosis or dynamic corset. Patients were evaluated with Visual Analogue Scale, Oswestry Low Back Pain Disability Questionnaire, and measurement of forced expiratory volume in the first second. Regional kyphosis angle, Delmas Index, and height of the fractured vertebral body were also measured on full-spine X-rays. Follow-up intervals were 1, 3, and 6 months after trauma. The complications encountered during the 6-month follow-up were recorded. Results At the 3- and 6-month follow- ups, there was a significant difference (p < 0.05) in pain, disability, and respiration in favor of the dynamic orthosis group. At 6-month follow-up, there was no significant difference (p > 0.05) in all the radiological parameters between groups. Complications were reported for 28 patients in the three-point orthosis group, and for eight patients in the dynamic corset group (p < 0.05). Discussion Biofeedback activation of back muscles is probably a key factor in improving functional outcome with dynamic orthosis. Conclusions Compared to three-point orthosis, patients treated with dynamic orthosis had a greater reduction in pain and a greater improvement in quality of life and respiratory function, with equal effectiveness in stabilizing the fracture, and fewer complications.