外傷性胸腰椎移行部圧迫骨折の保存的治療における反張型体幹装具の治療効果に関する臨床的格付け

Comparison Between the Efficacy of the Jewett Brace and Rigid Lumbar Corset as Conservative Treatment for Traumatic Fractures of the Thoracolumbar Spine

　目的：2010年4月～2011年12月の間に入院治療した外傷性胸腰椎移行部圧迫骨折の患者で，反張型腰椎装具(Jewett型装具と硬性体幹装具)の効果を，前向きに調査した．

　方法：治療は受傷時から3週間は臥床安静し，離床期に各装具を3カ月装着させた．

　結果：Jewett型装具群が11例12椎体，硬性体幹装具群が10例10椎体で，平均年齢68.4歳，平均経過期間167.2日であった．入院期間や臨床症状，放射線学的検討において，両群に有意な差は認めなかった．

　結論：Jewett型装具と硬性体幹装具の治療効果は同等と考えられた．

　Background：We report a prospective study of conservative therapy that was used to treat patients with a traumatic compression fracture of the thoracolumbar spine between April 2010 and December 2011.

　Methods：The patients were randomly divided into 2 groups：a Jewett brace group and a rigid lumbar corset group.　The patients in both groups were treated by bed rest for 3 weeks after the trauma, and then wore the brace or corset for 3months.

　Results：There were 10 patients in the Jewett brace group and 11 patients in the rigid lumbar corset group.　At the and of the 3 months there were no significant differences between the Jewett brace group and rigid lumbar corset group in vertebral deformities, such as %-compression and local kyphosis angle.

　Conclusion：The two braces were equally effective as a treatment for traumatic thoracolumbar fractures according to our protocol.