- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03952182
Effect of Bracing Versus No Bracing in Stable Thoracolumbar Compression and Burst Fractures
March 22, 2022 updated by: William Behrens, MD, St. Louis University
Spinal orthoses have been used in the treatment of non-operative thoracic and lumbar fractures with much success.
However, there has been increasing questioning as to wether or not the orthotics are necessary to have a good overall outcome.
Being fitted for and acquiring braces are associated with great expense and increased hospital stays.
The purpose of this study is to determine wether or not braces are required for good outcome post thoracic or lumbar fracture.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
Several tens of patient's per year come to the Emergency Department with thoracolumbar spine compression and burst fractures that are not indicated for surgical fixation.
Currently, these patients are treated non-operatively through brace wear which is either custom made for the patient or is off-the-shelf pending location of the fracture and surgeon preference.
All braces are through the currently contracted orthotics company.
As they are non stocked in house, waiting for the brace requires the patients to remain on "strict spine precautions" (flat bed rest in a Miami J collar, no pillows behind the head, and logrolls for turning) for anywhere from 24-48 hours.
No only is this incredibly uncomfortable for the patient, it is also extending their hospital stay for at least one day and, sometimes, up to three as they wait for the brace and have it adjusted to fit appropriately.
The patient's all have to then wait to work with physical therapy and occupational therapy and, finally, have upright spine films taken in the brace.
The braces tend to be very uncomfortably and constricting for patient's and significantly inhibit their daily lives.
The investigators are proposing that these fractures can be treated without needing bracewear and will have equivalent to superior outcomes than results while wearing the brace.
Study Type
Interventional
Enrollment (Actual)
1
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Missouri
-
Saint Louis, Missouri, United States, 63110
- Saint Louis University Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Any acute, stable thoracic or lumbar compression or burst fracture appropriate for non-operative care
Exclusion Criteria:
- neurological deficit, pregnant, incarcerated, non-English speaking, previous spinal surgery, additional lower extremity injury affecting weight bearing, younger than 18 years of age
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Spinal Orthosis (LSO, TLSO, etc)
Patient's in this arm will be given an orthosis for the treatment of their injury (TLSO for thoracic or upper lumbar injury, LSO for lumbar injury)
|
spinal orthosis prescribed for specific spinal fracture (TLSO for thoracic or high lumbar fracture, LSO for lumbar fracture)
|
Experimental: No Spinal Orthosis
the patient's in this arm will not be given an orthotic.
They will be given a bending restriction and otherwise remain activities as tolerated.
|
no orthotic given for spinal fracture.
These patient's will be given a bending restriction
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oswestry Disability Index (ODI)
Time Frame: 6 month post-injury
|
Primary outcome is the ODI which is a a self-completed questionnaire over ten topics regarding pain, lifting, ability to perform activities of daily living, ability to walk, sit, stand, one's sexual function, social life, sleep quality, and ability to travel.
Each category has six different statements from which the patient can choose to best describe their current status.
Each question is then scored on a scale from 0-5.
Scores are summed and then doubled.
The index is from 0-100 with zero being no disability and one hundred being maximally disabled.
|
6 month post-injury
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Visual analog scale (VAS)
Time Frame: Time of injury and at follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
VAS is a continuous scale represented as a horizontal line with vertical dashes numbered 0-10.
Each number is given a pain intensity descriptor that ranges from "no pain" (score of 1) to "worst imaginable pain" (score of 10).
The patient is asked to rate the pain they are currently experiencing on that scale from 1-10
|
Time of injury and at follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
SF-12
Time Frame: time of injury and follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
time of injury and follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
|
PROMIS (Patient-Reported Outcomes Measurement Information System)- physical function
Time Frame: time of injury and follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
PROMIS is a U.S. NIH initiative that is an item bank of self-administered questions to measure physical function.
This includes functionality of one's upper extremities (dexterity), lower extremities (mobility), neck, back, as well as ability to perform activities of daily living.
This assessment measures current function rather than function over a time period.
Each question has five response options ranging in value from 1-5.
The total raw score for the form is the sum of the values of the response to each question.
The raw score (which can range from 10 (worst) to 50 (best) is then compared to a PROMIS specific conversion chart to the appropriate T-score.
A T-score of roughly 50 is considered 'average' and 'slightly sicker than the general population'.
|
time of injury and follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
Return to Work Status
Time Frame: follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
Patient's will be asked if they currently work at time of injury and at each consecutive follow up appointment will be asked if they have returned to work
|
follow up at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 5, 2020
Primary Completion (Actual)
March 15, 2020
Study Completion (Actual)
March 22, 2022
Study Registration Dates
First Submitted
May 13, 2019
First Submitted That Met QC Criteria
May 14, 2019
First Posted (Actual)
May 16, 2019
Study Record Updates
Last Update Posted (Actual)
March 24, 2022
Last Update Submitted That Met QC Criteria
March 22, 2022
Last Verified
March 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 29976
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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