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Treatment with or without an Orthosis is Equivalent for Thoracolumbar Burst Fracture without Neurologic Injury.

Bailey CS, Urquhart JC, Dvorak MF, Nadeau M, Boyd MC, Thomas KC, Kwon BK, Gurr KR, Bailey SI, Fisher CG. Orthosis Versus No Orthosis for the Treatment of Thoracolumbar Burst Fractures without Neurologic Injury: A Multicenter Prospective Randomized Equivalence Trial. Spine J. 2014 Nov 1;14(11):2557-64.

### Question:

In patients with a burst fracture of the thoracolumbar spine, is treatment with a thoracolumbosacral orthosis (TLSO) equivalent to treatment without a TLSO?

### Design:

Randomized (allocation concealed), blinded (outcome assessors), controlled trial with 24 months of follow-up.

### Setting:

3 Canadian tertiary spine centers.

### Patients:

96 neurologically intact patients who were 16 to 60 years of age (mean age, 40 years; 70% men) and had sustained, within the past 3 days, an isolated AO-A3 burst fracture between T10 and L3 with a kyphotic deformity of <35°. Exclusion criteria included the inability to wear a brace, mobilization with or without a brace before recruitment, pathologic or open fracture, drug or alcohol dependence, and previous injury or surgery to the thoracolumbar region. Data were available for 92 patients (96%) for measurement of the primary outcome at 3 months; the rate of follow-up was 71% at 24 months.

### Intervention:

Patients were allocated to treatment with (n = 47) or without (n = 49) a …