Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
J Back Musculoskelet Rehabil. 2024;37(4):929-941. doi: 10.3233/BMR-230177.
Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated.
This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management.
This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a dynamic spinal orthosis (Spinfast®). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured.
The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p< 0.0001).
The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF.
椎体脆性骨折（VFF）通常是由于骨量减少和骨组织微结构恶化引起的。脊柱矫形器是管理椎体骨折疼痛的常用非药物选择。然而，脊柱矫形器对疼痛、身体功能和生活质量（QoL）的影响仍存在争议。
本研究旨在调查一种动态脊柱矫形器在 VFF 管理常规临床实践中的患者报告结局。
这是一项多中心全国范围的前瞻性队列研究，评估了诊断为急性 VFF 并接受动态脊柱矫形器（Spinfast®）治疗的老年患者（年龄>60 岁）。设计了一份调查问卷，包括患者特征、骨质疏松症特征、脊柱矫形器、临床结局、疼痛药物和骨质疏松症药物等部分。在基线和三个月后进行问卷调查。共有 68 名患者在三个月时完成了问卷。大多数患者有一个或两个 VFF，并接受疼痛药物和骨质疏松症药物治疗。评估了脊柱矫形器的依从性和耐受性，以及疼痛强度、身体功能和 QoL 等临床结局。
结果显示，不同年龄亚组之间的结局无显著差异。意大利物理医学和康复医师通常参与 VFF 患者的管理。66 名患者完成了问卷。结果表明，佩戴脊柱矫形器三个月后疼痛强度、身体功能和 QoL 均有所改善（p<0.0001）。
正确管理 VFF 对于改善疼痛和减少残疾至关重要，我们的研究结果表明，动态脊柱矫形器在改善 VFF 患者的综合管理方面发挥了积极作用。然而，需要高质量的研究试验为 VFF 的正确临床管理提供明确的建议。
