BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is...BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith 展开更多
目的通过Meta分析探讨经皮椎体成形术(PVP)/经皮椎体后凸成形术(PKP)后邻椎再骨折的危险因素。方法计算机检索中国生物医学文献数据库、中国知网、万方、维普、PubMed、Web of Science、Embase等中英文数据库,检索词主要包括“骨水泥成...目的通过Meta分析探讨经皮椎体成形术(PVP)/经皮椎体后凸成形术(PKP)后邻椎再骨折的危险因素。方法计算机检索中国生物医学文献数据库、中国知网、万方、维普、PubMed、Web of Science、Embase等中英文数据库,检索词主要包括“骨水泥成形术”“椎体成形术”“再骨折”“vertebroplasty”“kyphoplasty”“refracture”等,根据纳入及排除标准筛选文献后,使用NOS严格评价文献质量,提取相关数据后使用RevMan 5.3软件进行统计分析。结果最终共纳入19篇文献,均为病例对照研究,研究对象共3678例,其中病例组523例,对照组3155例;通过Meta分析认为PVP/PKP后邻椎再骨折的危险因素包括骨密度较低[OR=5.57(95%CI:4.08,7.59)]、术前椎体陈旧性骨折数量过多(≥2)[OR=2.38(95%CI:1.14,4.96)]、椎体骨折数量过多(≥2)[OR=5.78(95%CI:4.30,7.76)]、术后未行抗骨质疏松治疗[OR=3.74(95%CI:1.79,7.80)]、高龄[OR=3.51(95%CI:2.72,4.52)]、低BMI[OR=1.57(95%CI:1.17,2.10)]、骨水泥过量[OR=3.92(95%CI:2.39,6.45)]、手术椎体数量过多(≥2)[OR=5.01(95%CI:3.08,8.17)]、伤椎高度过度恢复[OR=2.66(95%CI:1.78,3.97)]、术后椎体后凸角过大[OR=3.55(95%CI:2.41,5.22)]、骨水泥渗漏[OR=4.79(95%CI:3.25,7.05)]。结论PVP/PKP后邻近椎再骨折的危险因素较多,临床上应做好术前评估及术后预防,以避免PVP/PKP后邻椎再骨折发生。展开更多
文摘BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith
文摘目的通过Meta分析探讨经皮椎体成形术(PVP)/经皮椎体后凸成形术(PKP)后邻椎再骨折的危险因素。方法计算机检索中国生物医学文献数据库、中国知网、万方、维普、PubMed、Web of Science、Embase等中英文数据库,检索词主要包括“骨水泥成形术”“椎体成形术”“再骨折”“vertebroplasty”“kyphoplasty”“refracture”等,根据纳入及排除标准筛选文献后,使用NOS严格评价文献质量,提取相关数据后使用RevMan 5.3软件进行统计分析。结果最终共纳入19篇文献,均为病例对照研究,研究对象共3678例,其中病例组523例,对照组3155例;通过Meta分析认为PVP/PKP后邻椎再骨折的危险因素包括骨密度较低[OR=5.57(95%CI:4.08,7.59)]、术前椎体陈旧性骨折数量过多(≥2)[OR=2.38(95%CI:1.14,4.96)]、椎体骨折数量过多(≥2)[OR=5.78(95%CI:4.30,7.76)]、术后未行抗骨质疏松治疗[OR=3.74(95%CI:1.79,7.80)]、高龄[OR=3.51(95%CI:2.72,4.52)]、低BMI[OR=1.57(95%CI:1.17,2.10)]、骨水泥过量[OR=3.92(95%CI:2.39,6.45)]、手术椎体数量过多(≥2)[OR=5.01(95%CI:3.08,8.17)]、伤椎高度过度恢复[OR=2.66(95%CI:1.78,3.97)]、术后椎体后凸角过大[OR=3.55(95%CI:2.41,5.22)]、骨水泥渗漏[OR=4.79(95%CI:3.25,7.05)]。结论PVP/PKP后邻近椎再骨折的危险因素较多,临床上应做好术前评估及术后预防,以避免PVP/PKP后邻椎再骨折发生。
