No evidence for the effectiveness of bracing in patients with thoracolumbar fractures.
OBJECTIVE
The use of braces is widespread in patients with thoracolumbar fractures. The effectiveness of bracing, however, is controversial. We sought evidence for the effect of bracing in patients with traumatic thoracolumbar fractures based on outcome and length of hospital stay (LOS). Furthermore, we evaluated the incidence of complications of bracing.


METHODS
An electronic search strategy with extensive MeSH headings was used in various databases to identify studies that compared bracing and non-bracing therapies. Two reviewers independently selected systematic reviews, randomized controlled trials (RCTs), controlled clinical trials, and observational studies, and both assessed the methodological quality and extracted the data.


RESULTS
No systematic reviews or RCTs were found. 7 retrospective studies were included. None of these studies showed an effect of bracing. Because of poor methodological quality, no best-evidence synthesis could be performed. One observational study was selected in which a complication of bracing was reported.


CONCLUSIONS
In the present literature, there is no evidence for the effectiveness of bracing in patients with traumatic thoracolumbar fractures. The lack of high-quality studies prevents relevant conclusions from being drawn.
Giele
Boukje M
BM
Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. B.M.Giele@amc.uva.nl
Wiertsema
Suzanne H
SH
Beelen
Anita
A
van der Schaaf
Marike
M
Lucas
Cees
C
Been
Henk D
HD
Bramer
Jos A M
JA
D001915:Braces / Q000009:adverse effects; D019317:Evidence-Based Medicine; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000293:injuries*; D017063:Outcome Assessment, Health Care; D016103:Spinal Fractures / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome