Bailey et.al. present the results of a multi-center, randomized, non-blinded equivalence trial with the goal of eliminating the cost, patient deconditioning and complications associated with the use of TLSO brace or body casts for thoraco-lumbar burst fractures. This study was based on the hypothesis that AO-A3 burst fractures between T11-L3, in neurologically intact, skeletally mature patients with <35 degree kyphotic deformity, are stable fractures. By randomizing 47 patients into the TLSO group and 46 patients into the “No orthoses” (NO) group both with early ambulation by a certified physical therapist, the authors sought to compare the effectiveness of these two treatment modalities. There was no statistically significant difference between the time to discharge, Roland Morris Disability questionnaire (RMDQ) at 3 months post-injury, visual analog scale pain, Short-Form Health Survey (SF-36), patient satisfaction scores, or degree of kyphosis between the two groups.
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