Objective: The objective of this study was to evaluate the effectiveness of bracing after percutaneous vertebroplasty (PVP) for thoracolumbar osteoporotic vertebral compression fractures (OVCF).
Methods: This is a retrospective study where we recruited 138 patients with single-level thoracolumbar OVCF who underwent PVP from January 2018 to March 2018 without bracing after PVP (Group A). The visual analog score (VAS) and vertebral body compression ratio (VCR) were recorded at preoperation, on the second day, at 2 weeks, 1 month, and 6 months after operation. Oswestry Disability Index (ODI) was recorded at preoperation, 2 weeks, 1 month, and 6 months after operation. Propensity score matching identified 138 historical patients (Group B) as controls, who used rigid brace for 3 weeks after the surgery, from January 2017 to December 2017 using six independent variables (preoperation): age, sex, VAS, ODI, bone mineral density, and body mass index. The indicators and complications were compared between the two groups.
Results: Compared with preoperation, VAS and VCR were significantly improved (P <0.05) in both groups on the second day after operation. At 2 weeks, 1 month, and 6 months after PVP operation, ODI, VAS, and VCR were all significantly improved than at preoperation (P <0.05). There were no statistical differences between the two groups in VAS and VCR on the second day, at 1 month and 6 months after PVP (P >0.05). There were no significant differences between Groups A and B in ODI at 2 weeks and 6 months after operation (P >0.05) but ODI for Group B at 1 month after operation was significantly higher than Group A (P <0.05). Eleven cases in Group A and 13 cases in Group B had poor pain relief on the second day after operation, and there were no significant differences in VAS and ODI between the two subgroups at 2 weeks, 1 month, and 6 months after PVP. There were no significant differences in the collapse and refracture rates between the two groups.
Conclusion: In summary, in terms of quality of life and complications after operation, postoperative bracing did not result in improved outcomes. Presence or absence of bracing did not relieve postoperative residual pain. In contrast, bracing for 3 weeks after operation reduced the quality of life in the short term.
Keywords: percutaneous vertebroplasty, osteoporotic vertebral compression fractures, brace