Jamil Hmida, Yorck Rommelspacher, Thomas Hilberg, Marius Brühl, Jonas Roos, Frank A Schildberg, Max Jaenisch, Andreas C Strauss
{"title":"后凸成形术后矫形的随机对照试验：活动、疼痛和姿势。","authors":"Jamil Hmida, Yorck Rommelspacher, Thomas Hilberg, Marius Brühl, Jonas Roos, Frank A Schildberg, Max Jaenisch, Andreas C Strauss","doi":"10.1007/s00586-025-09433-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The successful conservative treatment of spinal osteoporotic fractures with orthoses has been extensively studied in the past, but data on the benefit of additional orthotic treatment after kyphoplasty are lacking. The aim of this study was to examine the influence of a thoracolumbar orthosis (TLO) on movement activity, pain perception, and functional parameters after kyphoplasty of osteoporotic spinal fractures.</p><p><strong>Methods: </strong>This randomized-controlled-trial included patients with osteoporotic spine fractures of the thoracal and lumbar spine with indication for primary kyphoplastic treatment. The intervention group postoperatively wore a TLO for eight weeks (controlled by a thermal sensor and diary) while the control group did not receive an orthosis. Both groups were equipped with an activity tracker to determine step activity during this time. An examination of activity, pain perception, and functional parameters was performed pre- and immediately postoperatively as well as 2/8/12/24 weeks after surgery.</p><p><strong>Results: </strong>Fifty five patients (mean age: 69 ± 7 years) were included in this study. Over the 8-week postoperative period, both groups showed significant changes in step activity (p = 0.003) but no group difference (p = 0.891). Furthermore, no group differences were seen in weekly activity, pain perception, and functional parameters (p = 0.580; 0.298; 0.529). According to the temperature measurement, participants in the intervention group wore the orthosis for an average of 2.8 h per day but stated to wear it 4-6 h per day in their diaries.</p><p><strong>Conclusions: </strong>The TLO showed no influence on postoperative physical conditions after kyphoplasty. However, tendencies of lower pain perception in the intervention group could be shown. The contrast between objective and subjective wearing time highlights the significance of sensitizing patients in wearing orthoses to achieve a clinically relevant outcome. The reduced wearing time could have influenced the results, which probably means that the effects cannot be fully utilized. For this reason, additional training in way of wearing and duration including control mechanisms as well as motivational systems are needed to improve the patient's compliance and the effect of the orthosis.</p><p><strong>Level of evidence: </strong>Therapeutic Level I.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Randomized controlled trial of orthosis after kyphoplasty: activity, pain and posture.\",\"authors\":\"Jamil Hmida, Yorck Rommelspacher, Thomas Hilberg, Marius Brühl, Jonas Roos, Frank A Schildberg, Max Jaenisch, Andreas C Strauss\",\"doi\":\"10.1007/s00586-025-09433-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The successful conservative treatment of spinal osteoporotic fractures with orthoses has been extensively studied in the past, but data on the benefit of additional orthotic treatment after kyphoplasty are lacking. The aim of this study was to examine the influence of a thoracolumbar orthosis (TLO) on movement activity, pain perception, and functional parameters after kyphoplasty of osteoporotic spinal fractures.</p><p><strong>Methods: </strong>This randomized-controlled-trial included patients with osteoporotic spine fractures of the thoracal and lumbar spine with indication for primary kyphoplastic treatment. The intervention group postoperatively wore a TLO for eight weeks (controlled by a thermal sensor and diary) while the control group did not receive an orthosis. Both groups were equipped with an activity tracker to determine step activity during this time. An examination of activity, pain perception, and functional parameters was performed pre- and immediately postoperatively as well as 2/8/12/24 weeks after surgery.</p><p><strong>Results: </strong>Fifty five patients (mean age: 69 ± 7 years) were included in this study. Over the 8-week postoperative period, both groups showed significant changes in step activity (p = 0.003) but no group difference (p = 0.891). Furthermore, no group differences were seen in weekly activity, pain perception, and functional parameters (p = 0.580; 0.298; 0.529). According to the temperature measurement, participants in the intervention group wore the orthosis for an average of 2.8 h per day but stated to wear it 4-6 h per day in their diaries.</p><p><strong>Conclusions: </strong>The TLO showed no influence on postoperative physical conditions after kyphoplasty. However, tendencies of lower pain perception in the intervention group could be shown. The contrast between objective and subjective wearing time highlights the significance of sensitizing patients in wearing orthoses to achieve a clinically relevant outcome. The reduced wearing time could have influenced the results, which probably means that the effects cannot be fully utilized. For this reason, additional training in way of wearing and duration including control mechanisms as well as motivational systems are needed to improve the patient's compliance and the effect of the orthosis.</p><p><strong>Level of evidence: </strong>Therapeutic Level I.</p>\",\"PeriodicalId\":12323,\"journal\":{\"name\":\"European Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00586-025-09433-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00586-025-09433-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Randomized controlled trial of orthosis after kyphoplasty: activity, pain and posture.
Background: The successful conservative treatment of spinal osteoporotic fractures with orthoses has been extensively studied in the past, but data on the benefit of additional orthotic treatment after kyphoplasty are lacking. The aim of this study was to examine the influence of a thoracolumbar orthosis (TLO) on movement activity, pain perception, and functional parameters after kyphoplasty of osteoporotic spinal fractures.
Methods: This randomized-controlled-trial included patients with osteoporotic spine fractures of the thoracal and lumbar spine with indication for primary kyphoplastic treatment. The intervention group postoperatively wore a TLO for eight weeks (controlled by a thermal sensor and diary) while the control group did not receive an orthosis. Both groups were equipped with an activity tracker to determine step activity during this time. An examination of activity, pain perception, and functional parameters was performed pre- and immediately postoperatively as well as 2/8/12/24 weeks after surgery.
Results: Fifty five patients (mean age: 69 ± 7 years) were included in this study. Over the 8-week postoperative period, both groups showed significant changes in step activity (p = 0.003) but no group difference (p = 0.891). Furthermore, no group differences were seen in weekly activity, pain perception, and functional parameters (p = 0.580; 0.298; 0.529). According to the temperature measurement, participants in the intervention group wore the orthosis for an average of 2.8 h per day but stated to wear it 4-6 h per day in their diaries.
Conclusions: The TLO showed no influence on postoperative physical conditions after kyphoplasty. However, tendencies of lower pain perception in the intervention group could be shown. The contrast between objective and subjective wearing time highlights the significance of sensitizing patients in wearing orthoses to achieve a clinically relevant outcome. The reduced wearing time could have influenced the results, which probably means that the effects cannot be fully utilized. For this reason, additional training in way of wearing and duration including control mechanisms as well as motivational systems are needed to improve the patient's compliance and the effect of the orthosis.
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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