Vertebral compression fractures are the most common type of osteoporotic fracture. In the acute stage osteoporotic vertebral fractures cause severe back pain, disabilities in activities of daily living and deterioration in the quality of life. The efficacy of brace application for the treatment of osteoporotic compression fractures remains unclear. The purpose of this study was to compare the treatment outcome in patients with osteoporotic compression fracture with or without brace. We randomly assigned 42 patients with acute osteoporotic compression fractures within 2 wks of injury to the Brace and No Brace groups. Patients are followed up with clinical and radiological assessment till 6 months. The primary outcome was the Oswestry Disability Index score and secondary outcome measures were VAS for back pain, Body Compression Ratio and angle of kyphosis during the follow up interval. The Oswestry Disability Index score after compression fracture in the brace group was superior to that in the No brace group. During the follow-up assessment period, there was significant difference among the groups for the overall Oswestry Disability Index scores (p<0.001) and visual analog scale for pain scores for back pain. However, the Oswestry Disability Index scores and the visual analog scale scores for back pain significantly improved with time after the fractures (p< 0.001) in both groups. The body compression ratios significantly decreased (p=0.0414) and the cobbs angle significantly increased (p =0.0181) with time in No Brace group compared to traetment with Brace. The overall tolerability of the orthoses was good. Thereby, the use of an orthosis may represent an efficacious nonpharmacologic treatment option for spinal osteoporotic fractures.