I am a 26 year old female who suffered a compression fracture of my L1 vertebra approx. 6 weeks ago due to a MVA. I was pain free after two weeks discontiuned use of my TLSO back brace a few days ago, which was recommended for me to wear for three months. Some information I came across stated that back braces are primarily used for pain managment. I am pain free and I sit at a desk all day for work and have had no intense physical activity execpt short daily walks. Am I risking any major long-term negative effects such as paralysis or anything comparable by not using this brace throughout the term suggested?

Doctor Sinuhe Answers:

Thanks for your question. I wouldn’t second guess my doctor after having a compression fracture in my L1 and neither should you. Therefore, before stopping planned treatments you should consult your own doctor.

Having said that, it may very well be as you think - since you have no pain, wearing the brace may not give any extra benefit. And correct, a brace is often used to ease the pain. But this does depend on the type of the fracture and the type of the brace.

If it is just one vertebra and if the fracture is stable (with intact so called posterior column and the loss of vertebra height is less than 50%), you’re usually ok with no brace at all and with early mobilization.

Since you had no operation and an early mobilization, you most likely have no obvious threat of neurological damage (nothing is compressing your spinal cord or nerve roots), although you need to understand I can’t know this for a fact without actually seeing the X - rays/CT scans/MRI.

More likely threat in your case comes from the possibility of developing kyphosis (forward bending of your spine), the prevention of which is sometimes attempted by external immobilization in extension (with braces like for example Jewett hyperextension brace or molded TLSO). This may or may not be a risk in your case. So, please contact your doctor and ask him about dropping off the brace. And let us know what he said.

Dr Sinuhe