Effect of Bracing Versus No Bracing in Stable Thoracolumbar Compression and Burst Fractures

Saint Louis University (SLU)

Status: Terminated

Conditions: Compression Fracture of Lumbar Spine; Compression Fracture of Thoracic Vertebral Body; Thoracic Fracture; Burst Fracture of Thoracic Vertebra; Burst Fracture of Lumbar Vertebra; Lumbar Fracture

Treatments: Other: Spinal Orthosis (LSO, TLSO); Other: No orthosis

Study type: Interventional

Funder types: Other

Identifiers

NCT03952182

29976

Details and patient eligibility

About

Spinal orthoses have been used in the treatment of non-operative thoracic and lumbar fractures with much success. However, there has been increasing questioning as to wether or not the orthotics are necessary to have a good overall outcome. Being fitted for and acquiring braces are associated with great expense and increased hospital stays. The purpose of this study is to determine wether or not braces are required for good outcome post thoracic or lumbar fracture.

Full description

Several tens of patient's per year come to the Emergency Department with thoracolumbar spine compression and burst fractures that are not indicated for surgical fixation. Currently, these patients are treated non-operatively through brace wear which is either custom made for the patient or is off-the-shelf pending location of the fracture and surgeon preference. All braces are through the currently contracted orthotics company. As they are non stocked in house, waiting for the brace requires the patients to remain on "strict spine precautions" (flat bed rest in a Miami J collar, no pillows behind the head, and logrolls for turning) for anywhere from 24-48 hours. No only is this incredibly uncomfortable for the patient, it is also extending their hospital stay for at least one day and, sometimes, up to three as they wait for the brace and have it adjusted to fit appropriately. The patient's all have to then wait to work with physical therapy and occupational therapy and, finally, have upright spine films taken in the brace. The braces tend to be very uncomfortably and constricting for patient's and significantly inhibit their daily lives. The investigators are proposing that these fractures can be treated without needing bracewear and will have equivalent to superior outcomes than results while wearing the brace.

Enrollment: 1 patient

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Any acute, stable thoracic or lumbar compression or burst fracture appropriate for non-operative care

Exclusion criteria

• neurological deficit, pregnant, incarcerated, non-English speaking, previous spinal surgery, additional lower extremity injury affecting weight bearing, younger than 18 years of age

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1 participants in 2 patient groups

Spinal Orthosis (LSO, TLSO, etc)

Active Comparator group

Description:

Patient's in this arm will be given an orthosis for the treatment of their injury (TLSO for thoracic or upper lumbar injury, LSO for lumbar injury)

Treatment:

Other: Spinal Orthosis (LSO, TLSO)

No Spinal Orthosis

Experimental group

Description:

the patient's in this arm will not be given an orthotic. They will be given a bending restriction and otherwise remain activities as tolerated.

Treatment:

Other: No orthosis