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Postoperative bracing after vertebroplasty: a prospective randomized controlled study
Haimiti Abudouaini1, Guang Yang2, Jianbin Guan1
1Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi 710054, China; Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi 710054, China.
A mixed-brace protocol combining rigid and soft bracing offers superior recovery and pain relief after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). This sequential approach balances stability and comfort, improving patient outcomes compared to other bracing methods.
Area of Science:
- Orthopedics
- Spine Surgery
- Biomedical Engineering
Background:
- Postoperative lumbar bracing following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs) lacks consensus.
- Limited evidence exists comparing different types of postoperative braces.
Purpose of the Study:
- To evaluate the impact of four postoperative bracing strategies on recovery, pain, vertebral height maintenance, and quality of life after PVP.
- Investigate the efficacy of no-brace, soft-brace, rigid-brace, and a mixed-brace protocol.
Main Methods:
- Prospective randomized controlled trial with 160 participants with single-level OVCFs.
- Randomization into four groups: No-Brace, Soft-Brace, Rigid-Brace, and Mixed-Brace (4 weeks rigid, 8 weeks soft).
- Primary outcomes: Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pain and stiffness, Japanese Orthopedic Association (JOA) scores. Secondary outcomes: SF-36 scores and anterior body compression ratio (ABCR).
Main Results:
- All groups demonstrated significant improvements in function and pain over 12 weeks.
- The Mixed-Brace group showed the lowest ODI and highest JOA scores at 12 weeks, with significantly better outcomes than the Rigid-Brace group.
- Rigid and Mixed Braces better preserved vertebral height compared to Soft or No-Brace. No adverse events were reported.
Conclusions:
- A sequential mixed-brace protocol (early rigid, then soft) provides the optimal balance of stability, comfort, and psychological well-being post-PVP.
- This mixed-brace strategy outperforms rigid- or soft-only bracing for short-term recovery after vertebroplasty.
