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European Spine Journal

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Open Access 26-08-2023 | Osteoporosis | Original Article

Vertebral compression fractures managed with brace: risk factors for progression

Authors: R. Gutierrez-Gonzalez, C. Ortega, A. Royuela, A. Zamarron

Published in: European Spine Journal | Issue 11/2023

Abstract

Purpose

The aim of this study is to identify risk factors for vertebral compression fracture (VCF) progression in patients treated conservatively with a brace. Then, a case–control study was designed.

Methods

All patients over 50 years old with diagnosis of thoracic or lumbar VCF (T5 to L5) in absence of underlying oncological process, treated conservatively with brace, and consecutively attended at our department from January 2017 to June 2021 were retrospectively selected for analysis. Patients missed for follow-up or dead during the first 3 months of follow-up were excluded.

Results

Five hundred and eighty-two consecutive patients were recorded. Incomplete follow-up excluded 74 patients and other 19 died in the first three months after diagnosis, so 489 cases were finally analyzed. Median follow-up was 21 (IQR 13;30) weeks. Increased collapse of the vertebral body was found in 29.9% of VCFs with a median time to progression of 9 (IQR 7;13) weeks. Male gender (OR 1.6), type A3 fracture of the AOSpine classification (OR 2.7), thoracolumbar junction location (OR 1.7), and incorrect use of the brace (OR 3.5) were identified as independent risk factors for progression after multivariable analysis.

Conclusion

Male gender, type A3 fracture of the AOSpine classification, thoracolumbar junction location, and incorrect use of the brace were identified as independent risk factors for VCF progression, which resulted in worse pain control, when treated with brace. Thus, other treatments such as percutaneous vertebral augmentation could be considered to avoid progression in selected cases, since collapse rate has been demonstrated lower with these procedures.

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Title: Vertebral compression fractures managed with brace: risk factors for progression
Authors: R. Gutierrez-Gonzalez
C. Ortega
A. Royuela
A. Zamarron
Publication date: 26-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Osteoporosis
Osteoporosis
Published in: European Spine Journal / Issue 11/2023
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07905-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Vertebral compression fractures managed with brace: risk factors for progression

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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