Abstract：
Background and purpose: Osteoporotic hyperkyphosis is associated with adverse outcomes, such as fatigue, back pain, or reduced back extensor strength, with a negative impact on functionality and quality of life. The purpose of this review is to assess the effectiveness of spinal orthosis on these adverse effects. Methods: A systematic review following the PRISMA guidelines was performed. Inclusion criteria were (1) women with osteoporosis; (2) randomized controlled trials only; and (3) type of intervention: spinal bracing. Exclusion criteria were (1) article not written in English; (2) full-text not available; and (3) no kyphosis assessment. Quality-of-life variables such as back pain, functional variables such as back extensor strength, and osteoporotic-related variables such as lumbar spine bone mineral density were extracted and recorded before and after the intervention. The characteristics of the intervention programs were also extracted and recorded. The characteristics of studies, interventions, and participants are summarized in a table. Then, the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the quality of the studies. Results and Discussion: Four randomized controlled trials with a low risk of bias were included (n = 326 women with osteoporosis, aged 51-93 years). Interventions consisting of wearing a dynamic hyperextension orthosis for at least two hours per day for six months improved functionality, mobility, back extensor strength, respiratory function, and reduced the thoracic kyphosis angle. Conclusions: Spinal orthosis, especially dynamic hyperextension braces, seems effective in improving the adverse outcomes of osteoporotic hyperkyphosis. It does not seem necessary to wear the orthosis during all daily activities.
摘要：
背景与目的：骨质疏松性高脊柱后凸与不良预后相关，比如疲劳，背痛,或者背部伸肌强度降低，对功能和生活质量有负面影响。这篇综述的目的是评估脊柱矫形器对这些不良反应的有效性。方法：遵循PRISMA指南进行系统评价。纳入标准是（1）骨质疏松症的女性；（2）仅随机对照试验；（3）干预类型：脊柱支撑。排除标准是（1）文章不是用英语写的；（2）全文不可用；（3）没有脊柱后凸评估。生活质量变量，如背痛，功能变量，如背伸肌强度，在干预前后提取并记录与骨质疏松相关的变量,如腰椎骨密度.还提取并记录了干预计划的特征。研究的特点，干预措施，和参与者总结在一个表格中。然后，我们使用修订后的Cochrane随机试验偏倚风险工具(RoB2)评估研究质量.结果与讨论：纳入了四个低偏倚风险的随机对照试验（n=326名骨质疏松症女性，51-93岁）。干预措施包括每天佩戴动态过伸矫形器至少两小时，持续六个月改善功能，移动性,背伸肌力量,呼吸功能,减小了胸椎后凸的角度.结论：脊柱矫形器，尤其是动态过伸牙套,似乎在改善骨质疏松性后凸畸形的不良结局方面有效。似乎没有必要在所有日常活动中佩戴矫形器。
