J Korean Med Sci.  2016 Oct;31(10):1641-1649. 10.3346/jkms.2016.31.10.1641.

Effect of Brace to Osteoporotic Vertebral Fracture: a Meta-Analysis

• Jin YZ
• Lee JH

• KMID: 2468257
• DOI: http://doi.org/10.3346/jkms.2016.31.10.1641

Abstract

Brace is one of the most commonly used interventions to manage osteoporotic vertebral fracture. However, its authentic effectiveness remains unclear. The aim of this study was to investigate the efficacy of brace in patients with osteoporotic vertebral fractures. We conducted a literature review and meta-analysis following the guideline and handbook of the Cochrane collaboration. Ten published articles were included in this study and data from 4 randomized controlled trials were analyzed. Low quality evidence proved using Spinomed brace could bring large and significant beneficial effect to patients with sub-acute osteoporotic vertebral fractures. Very low quality evidence proved no significant difference between Spinomed orthosis, rigid brace and soft brace when they were used in patients with acute fractures. Therefore, it might be applicable to recommend middle term use of Spinomed orthosis to patients with subacute fracture. In addition, this study emphasized the need for high quality randomized controlled trials.

Keyword

Spine; Osteoporosis; Fracture; Brace; Meta-Analysis

MeSH Terms

*Braces
Clinical Trials as Topic
Databases, Factual
Humans
Osteoporosis/complications
Osteoporotic Fractures/etiology/*therapy
Risk

Figure

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  Fig. 1 Flow diagram of selection process.

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  Fig. 2 Risk of bias table of included randomized controlled trials. Green represents "low risk of bias"; yellow, "unclear risk of bias"; red, "high risk of bias".

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  Fig. 3 Forest plot. Comparison between brace group and no brace group. Use of brace showed significant efficacy on pain (A), kyphosis angle correction (B), and quality of life (C).

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  Fig. 4 Result of the sensitivity analysis of excluding one of the two trials with unclear risk of reporting bias. The outcome of quality of life became insignificant after excluding data of Pfeifer et al., 2004 (A→B).

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  Fig. 5 Forest plot. Comparison between un-soft brace group and soft brace group. The results showed no significant difference between braces in pain (A), kyphosis angle (B) and quality of life (C).

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