Is postoperative bracing after pedicle screw fixation of spine fractures necessary? Study protocol of the ORNOT study: a randomised controlled multicentre trial
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  • Published on:
    Types of fractures and a bone strength
    • Dimitar Minkov, Orthopedic Surgeon Medical University Pleven, Bulgaria

    The type of vertebral fractures object of the study of Smits et al. is defined as A2-C by AO [1]. The classification of AO of a thoracolumbar fracture includes three types of fractures: type A, type B and type C. Accordingly, type A has five subtypes:
    А0 – minor, nonstructural fractures;
    А1 – wedge-compression;
    А2 – split;
    А3 – incomplete burst;
    А4 – complete burst .
    Thoracolumbar fractures of type A2-C are not present in the AO classification [2].
    The article states that forty-six patients enrolled in the study were between 18 to 65 years of age but did not refer to the distribution of patients by age and gender. The bone quality will be different in one 18-year-old patient and a 65-year-old patient respectively [3]. Bone quality is important for the attachment of pedicular screw synthesis and it can be compromised in osteoporotic patients [4,5]. The use of three-point hyperextension brace in these patients postoperatively would be advisable [6].

    Abbreviation: AO – Müller AO Classification of fractures.


    1. Smits AJ, Deunk J, Stadhouder A, Altena MC, Kempen DHR, Bloemers FW. Is postoperative bracing after pedicle screw fixation of spine fractures necessary? Study protocol of the ORNOT study: a randomised controlled.
    2. Spinal Fractures Classification System - AO: Tools....

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    Conflict of Interest:
    None declared.