Anesthesia Management: Is Bracing Helpful in Patients with Vertebral Compression Fractures?

Authors: Kim H-J et al., J Bone Joint Surg Am 2014 Dec 3; 96:1959

In a randomized trial, bracing did not improve pain and function, compared with no bracing.

Patients with osteoporotic vertebral compression fractures sometimes are advised to wear back braces to relieve pain and improve early mobility. In this trial, researchers in Korea randomized 60 older adults with single acute thoracic or lumbar vertebral compression fractures to receive a rigid brace, a soft brace, or no brace. Exclusion criteria included malignancy, neurological compromise, or inability to walk before the fracture. Patients in the two brace groups were asked to wear their braces at all times — except when lying down — for 8 weeks. Pain and disability scores were recorded on standardized scales at 2, 6, and 12 weeks.

During follow-up, mean scores improved substantially in all three groups, with no differences between groups at any time point. Opioid use also was similar in the three groups.

Comment
Back braces are ineffective for patients with vertebral compression fractures, according to this study. In addition, braces have downsides: They can be cumbersome, and they can irritate the skin.