A Systematic Review: Othoses For Osteoporotic Vertebral Fractures

Background: Experimental and clinical data indicate that orthoses can relieve pain by supporting and stabilizing, accelerate healing by immobilizing and protecting. Orthoses and braces have been widely used in the rehabilitation of osteoporotic vertebral fractures worldwide. However, it's not clear that enough evidence supports orthoses as the effective treatment of osteoporotic vertebral fractures.Objective: We reviewed systematically all the randomized and quasi-randomized controlled trials of orthoses for osteoporotic vertebral fractures. The objective was to determine the curative effects and security of orthoses in patients with osteoporotic vertebral fractures.Materials and Methods: According to the inclusion, first, searches were performed in Cochrane Controlled Trials Register (CCTR/CENTRAL) Musculoskeletal Group Specialized Trial Register, EMBASE, MEDLINE CINAHL PEDRO Chinese Biological Medicine Database. We searched TrialsCentral? (www.trialscentral.org) and Current ControlledTrials(www.controlled-trials.com) on the internet , contented experts to obtain the latest research. Second, we handsearched reference lists of all the trials selected through the electronic search to identify additional trials. Two reviewers included studies, assessed the quality of studies, extracted data independently. Disagreement was resolved in a consensus meeting. When disagreement persisted a third person made the final decision. Last, the following outcomes were assessed:(l) kyphosis; (2) body height; (3) lung function; (4) muscle strength; (5) balance; (6) pain; (7) disability/ADL; (8) quality of life. For these continuous outcomes, weighted mean difference and 95% confidence interval were calculated and pooled using RevMan 4.2.7 software provided by Cochrane collaboration.Results: 16 potentially eligible trials were identified, of which one trial (62 cases) was included, nine were excluded, six are waiting for assessment. The meta-analysis showed compared to non-orthoses, orthoses significantly improved kyphosis (WMD -6.30 95%CI -8.89 --3.71), muscle strength (WMD 94.87 95%CI 68.48-121.25), lung function (WMD 10.36 95%CI 4.60-16.12), body height (WMD 5.70 95%CI 2.93-8.47), pain (WMD -1.60 95%CI -2.13--1.07), disability/ADL(WMD -1.48 95%CI -1.83 --1.12) and quality of life(WMD 12.70 95%CI 9.73 -15.67) in patients with non-acute osteoporotic vertebral fractures; no significant improvement was found in balance(WMD -0.62 95%CI -1.24-0.00); no adverse effects were found in the period of treatment, and the compliance of wearing orthoses was good.Conclusion: The study indicates that the present evidence shows orthoses have the tendency to improve kyphosis, muscle strength, lungfunction, body height, pain, disability/ADL and quality of life of non-acute osteoporotic vertebral fractures, and have some curative effects. But at present there's no enough evidence to support that orthoses can treat osteoporotic vertebral fractures effectively. It's not recommended that orthoses can be as the regular treatment of osteoporotic vertebral fractures. We included too few patients and studies, further randomized controlledtrials of high quality are needed.