Spinal Fractures Clinical Trial
Official title:
Thoracolumbar Burstfractures, Orthesis or no Orthesis
Rationale: Thoracolumbar burst fractures are frequently seen in the trauma population, they
have a large impact on patient's wellbeing and are a large economic burden to society.
Thoracolumbar burst fractures might not need the standard care of brace immobilization for
adequate treatment and a functional treatment might lead to same or better functional
outcomes. Besides that, with functional outcome length of hospital stay might decrease and
it might also be cost effective compared to bracing.
Objective: The investigators aim to study the use of braces for thoracolumbar
burstfractures, not only by measuring the functional scores and the effect of the bracing or
functional treatment on the increase in kyphosis angle, but also on (health related) quality
of life and health economics. The investigators hypothesize that no treatment is superior
over one other.
Study design: This project is a randomised controlled trial comparing brace and no brace
treatment on function, kyphosis angle, pain, quality of life, and costs.
Study population: Patients between 18 and 65, with a single level thoracolumbar burst
fracture will be included. The fracture has to have a kyphosis angle of less than 35 degrees
and patient has to be neurologically intact. Patients are excluded when they are overweight
(BMI> 35), need multidisciplinary treatment due to multitrauma, or have inadequate knowledge
of the Dutch language. Patients included in the brace group will automatically take part in
a brace compliance study.
Intervention: One group receives a Thoracolumbar Sacral Orthesis (TLSO) for 6 weeks, the
other group receives no TLSO Main study parameters/endpoints: The primary outcome of this
study is the functional score at six months after trauma. Secondary outcomes are pain,
kyphosis angle, health related quality of life, healthcare costs and brace compliance.
Literature shows no difference in pain, functional outcome or kyphosis angle, therefore no
potential risks are known comparing a brace and a functional treatment. Investigators aim
that not using the TLSO results in similar functional outcome, pain and kyphosis angle, and
less costs. Patients will be seen at first presentation and during two year follow up at the
outpatient clinic at six standard care follow up moments. At these follow up moments a X-ray
as part of standard care is made. At or just before each scheduled appointment they will
fill in questionnaires taking from 15-45 minutes.
No extra information ;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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