Vertebral compression fractures managed with brace: risk factors for progression
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. All patients over 50 years old with diagnosis of thoracic or lumbar VCF (T5 to L5) in absence of underlying...
| Autores: | , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/709019 |
| Acceso en línea: | http://hdl.handle.net/10486/709019 https://dx.doi.org/10.1007/s00586-023-07905-z |
| Access Level: | acceso abierto |
| Palabra clave: | fractures compression spinal fracture vertebral body retrospective studies follow-up studies Medicina |
| Sumario: | 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. 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 frst 3 months of follow-up were excluded. Five hundred and eighty-two consecutive patients were recorded. Incomplete follow-up excluded 74 patients and other 19 died in the frst three months after diagnosis, so 489 cases were fnally 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 classifcation (OR 2.7), thoracolumbar junction location (OR 1.7), and incorrect use of the brace (OR 3.5) were identifed as independent risk factors for progression after multivariable analysis. Male gender, type A3 fracture of the AOSpine classifcation, thoracolumbar junction location, and incorrect use of the brace were identifed 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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