Clinical and radiological subsequent fractures after vertebral augmentation for treating osteoporotic vertebral compression fractures: a meta-analysis

European spine journal

article

Hai-Bo Sun¹  Xiao-Shan Jing²  Hai Tang¹  Yong Hai³  Jin-Jun Li¹  Jian-Lin Shan¹  De-Cheng Wang⁴ 

[1] Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University (Capital Medical University Second Clinical Medical University);Department of Emergency, Beijing Friendship Hospital, Capital Medical University (Capital Medical University Second Clinical Medical University);Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University (Capital Medical University Third Clinical Medical University);Department of Orthopedics, Beijing Tongzhou Hospital of Integrated Chinese and Western Medicine

关键词: Osteoporotic vertebral compression fracture;    Percutaneous vertebral augmentation;    Vertebroplasty;    Kyphoplasty;    Conservative treatment;    Subsequent fracture;    Meta-analysis;   

DOI  :  10.1007/s00586-020-06560-y

来源: Springer

【 摘 要 】

This study aimed to identify all relevant randomized controlled trials (RCT) and prospective non-RCTs to further investigate whether percutaneous vertebral augmentation (PVA) was associated with clinical and radiological subsequent fractures on unoperated levels. We systematically searched PubMed, EMBASE, Cochrane library, Google Scholar, web of science, and ClinicalTrial.gov from the establishment of the database to January 2020. All eligible studies comparing subsequent fractures after PVA with those after conservative treatment (CT) were incorporated. The pooled risk ratio (RR) with its 95% confidence intervals (95% CIs) was used. Heterogeneity, sensitivity, and publication bias analyses were performed. In all, 32 studies were included in the study: 82/512 patients (16.02%) and 58/433 patients (13.39%) had clinical subsequent fractures in the PVA group and CT group, respectively. No significant differences were observed between the two groups [RR = 1.22, 95% CI 0.70–2.12, P = 0.49]. Further, 175/837 patients (20.91%) in the PVA group and 160/828 patients (19.32%) in the CT group had radiological subsequent fractures. No significant difference was observed between groups [RR = 0.91, 95% CI 0.71–2.12, P = 1.16]. Further, no statistical difference was observed on subgroup analysis between RCTs and non-RCTs or PVP and PKP. Our systematic review revealed that subsequent fractures on unoperated levels were not associated with PVA, regardless of whether they were clinical or radiological subsequent fractures.

【 授权许可】

Unknown