How Long Should a Brace Be Worn After a Burst Fracture?

How long should a brace be worn for a burst fracture?

Dr.
Chen, greetings! I was involved in a car accident on the highway, resulting in a "burst fracture of the third lumbar vertebra." In addition to the fracture, there is a compression of 0.3 cm.
Since there was no nerve damage, the attending physician has determined that "surgery is not necessary, and conservative treatment will be adopted, which includes bed rest and wearing a rigid back brace when getting up and moving."
1.
In general, how long does a patient in this situation need to wear the back brace?
2.
After "three months," is it possible to stop wearing the rigid back brace? Can it be replaced with a soft back brace?
3.
I have been wearing the brace for three months.
If I stop wearing it and suddenly have no support in my lower back, will I experience soreness at the site of the spinal injury or in my back? What other symptoms might occur? Is this normal?
4.
After stopping the use of the back brace, what should I be cautious about? For example, what movements should I avoid?
5.
I have not climbed stairs in the past three months.
If I attempt to "climb stairs without wearing the brace," will this put pressure on my spine and cause further injury (secondary compression)?
Thank you very much for your assistance and response.

Yuling, 30~39 year old female. Ask Date: 2023/10/25

Dr. Chen Bochen reply Orthopedics

Hello,
1.
A burst fracture requires wearing a brace for three months, with regular X-rays each month to monitor the healing process.

2.
After three months, you can switch to a soft brace.

3.
Initially wearing a soft brace, you can gradually increase walking and exercise, eventually reducing reliance on the back support.

4.
Avoid squatting, sitting too low, and bending while lifting heavy objects.

5.
Once the fracture has healed, there should be no risk of secondary compression from normal daily activities.

Reply Date: 2023/10/25

More Info

Dear Henry,
Thank you for reaching out regarding your concerns after your car accident. It sounds like you have been through a lot, and I understand your worries about your shoulder and elbow injuries. Based on the information you've provided, let's address your questions and concerns in detail.

1. Duration of Brace Use: After a burst fracture of the lumbar vertebra, the duration for which a brace should be worn can vary depending on the severity of the fracture and the individual’s healing process. Generally, a hard brace is recommended for about 8 to 12 weeks. Since you have already been wearing the brace for 3 months, it is essential to follow your physician's advice regarding when to transition to a soft brace or discontinue use altogether.
2. Transitioning from Hard to Soft Brace: After 3 months, many patients can start transitioning from a hard brace to a soft brace, but this should be done under the guidance of your healthcare provider. They will assess your healing through physical examinations and possibly imaging studies to determine if your spine is stable enough to support your body without the hard brace.

3. Symptoms After Discontinuing the Brace: It is common to experience some discomfort or soreness in the back after removing the brace, especially if your muscles have weakened during the immobilization period. The muscles and ligaments around the spine may need time to regain strength and stability. If you experience significant pain or any new symptoms, it is crucial to consult your doctor.

4. Precautions After Brace Removal: Once you stop wearing the brace, you should be cautious with movements that involve bending, twisting, or heavy lifting. Gradually reintroducing activities is key. Focus on strengthening exercises for your core and back muscles, as they play a vital role in supporting your spine. Your healthcare provider or a physical therapist can provide a tailored rehabilitation program to help you regain strength and mobility safely.

5. Climbing Stairs Without a Brace: Climbing stairs without a brace can put additional stress on your spine, especially if your core muscles are not yet strong enough to support your back. It is advisable to wait until you have been cleared by your physician to engage in such activities. If you do climb stairs, ensure you do so slowly and with support, such as holding onto a railing, to minimize the risk of injury.

In summary, it is crucial to follow your doctor's recommendations closely and communicate any concerns you have during your recovery process. Each individual's healing journey is unique, and your healthcare team is best equipped to guide you based on your specific situation.
Please remember that while it is normal to have concerns about your recovery, staying proactive about your rehabilitation and following medical advice will significantly enhance your chances of a full recovery. If you have any further questions or if your symptoms worsen, do not hesitate to reach out to your healthcare provider.

Wishing you a smooth recovery!
Best regards.

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