{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:56:58Z","timestamp":1772103418040,"version":"3.50.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:sec>\n            <jats:title>Study Design.<\/jats:title>\n            <jats:p>Survey study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective.<\/jats:title>\n            <jats:p>Assess practices and opinions of spine specialists from Europe and North America on orthosis use in adult patients with acute thoracolumbar (TL) fractures. Evaluate cost of the devices.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Summary of Background Data.<\/jats:title>\n            <jats:p>Although orthosis are traditionally used in conservative treatment of TL fractures, recent systematic reviews showed no benefit in patient's outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>A search for contact authors with publications on spine fractures from all European and North American countries was performed. An online questionnaire was sent on demographic data, practice setting, mean number of fractures treated, use of orthosis upon choice for conservative treatment, and average orthosis cost. Data was analyzed based in world regions, economic rank of the country, and health expenditure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>We received 130 answers, from 28 European and five North American countries. Most responders had more than 9 years of practice and worked at a public hospital. 6.2% did not prescribe a brace in any patient with acute TL fractures conservatively treated and 11.5% brace all patients. In a scale from 1 to 5, 21 considered that there is no\/low benefit (1) and 14 that bracing is essential (5), with a mean of 3.18. Europeans use orthosis less commonly than North Americans (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.05). Orthosis mean cost was $611.4\u200a\u00b1\u200a716.0, significantly higher in North America compared with Europe and in high income, when compared with upper middle income countries (both <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.05). Although hospital costs were not evaluated, orthosis is costlier when it involves admission of the patient (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a&lt;\u200a0.05). An increase in orthosis cost associated with higher gross domestic product (GDP) per capita and higher health expenditure was found.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion.<\/jats:title>\n            <jats:p>More than 90% of spine specialists still use orthosis in conservative treatment of adult patients with acute TL fractures. Orthosis cost vary significantly between continents, and it is influenced by the country's economy.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>Level of Evidence:<\/jats:bold> 4<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/brs.0000000000003769","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T00:51:02Z","timestamp":1604623862000},"page":"E534-E541","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Use and Cost of Orthosis in Conservative Treatment of Acute Thoracolumbar Fractures"],"prefix":"10.1097","volume":"46","author":[{"given":"Daniela","family":"Linhares","sequence":"first","affiliation":[{"name":"Center for Health Technology and Services Research, CINTESIS, Porto, Portugal"},{"name":"Health Information and Decision Sciences Department (MEDCIDS), Faculty of Medicine of University of Porto, Porto, Portugal"},{"name":"Ortopedia e Traumatologia \u2013 Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"RISE - Health Research from Lab to Community, University of Porto, Porto, Portugal."}]},{"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research, CINTESIS, Porto, Portugal"},{"name":"Health Information and Decision Sciences Department (MEDCIDS), Faculty of Medicine of University of Porto, Porto, Portugal"},{"name":"RISE - Health Research from Lab to Community, University of Porto, Porto, Portugal."}]},{"given":"Mnuel","family":"Ribeiro da Silva","sequence":"additional","affiliation":[{"name":"Ortopedia e Traumatologia \u2013 Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Orthopedics Department, Hospital CUF Porto, Porto, Portugal"}]},{"given":"Jo\u00e3o A.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Health Information and Decision Sciences Department (MEDCIDS), Faculty of Medicine of University of Porto, Porto, Portugal"},{"name":"Patient-centred Innovation and Technologies group (PaCeIT), Center for Health Technology and Services Research"},{"name":"Medicina, Educa\u00e7\u00e3o, I&D e Avalia\u00e7\u00e3o, Lda (MEDIDA), Porto, Portugal"},{"name":"Imunoalergologia, CUF Porto, Portugal"},{"name":"RISE - Health Research from Lab to Community, University of Porto, Porto, Portugal."}]},{"given":"Nuno","family":"Neves","sequence":"additional","affiliation":[{"name":"Ortopedia e Traumatologia \u2013 Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Orthopedics Department, Hospital CUF Porto, Porto, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"R1-20250501","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1097\/BRS.0000000000002923","article-title":"Epidemiology of spinal fractures in a level one trauma center in the netherlands: a 10 years review","volume":"44","author":"den Ouden","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"R2-20250501","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.injury.2008.06.040","article-title":"Epidemiology of traumatic spine fractures","volume":"40","author":"Leucht","year":"2009","journal-title":"Injury"},{"key":"R3-20250501","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1016\/S0003-9993(03)00265-X","article-title":"Years to employment after spinal cord injury","volume":"84","author":"Krause","year":"2003","journal-title":"Arch Phys Med Rehabil"},{"key":"R4-20250501","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1056\/NEJMcp1009697","article-title":"Clinical practice. 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