Risk factors for new vertebral compression fractures after percutaneous vertebroplasty: Qualitative

• 作 者: DanXing[1]XinLongMa[2]YangChen[1]WeiGuoXu[1]YangYang[1]ShaoWenZhu[1]JianXiongMa[3]JieWang[3]
• 机 构: Department of Orthopaedics Institute, Tianjin Hospital, 406 Jiefang Nan Street, Hexi District, Tianj
• 出 处: 第二十届全国中西医结合骨伤科学术研讨会、第二届中国医师协会中西医结合医师分会骨伤科学术年会、第十九届浙江省中西医结合骨伤
• 发表日期: 2013年期

　　Objective To identify the risk factors for new vertebral compression fractures (VCFs) in patients after percutaneous vertebroplasty (PVP) and to grade the evidence according to the quality of included studies.Background PVP is an effective procedure for the treatment ofVCFs.A major concern after PVP in patients with osteoporosis is the occurrence of new VCFs in the untreated vertebrae.The risk factors for new VCFs after PVP reported thus far remain controversial.These risk factors have neither been well identified or summarised.The present systematic review was performed to identify the risk factors for new VCFs after PVP.Methods Non-interventional studies evaluating the risk factors for new VCFs of patients with osteoporosis after PVP were searched in Medline, Embase, Sciencedirect and OVID database (all to Nov 2012).Only observational studies with eligible data were included.Quality of included studies was assessed by a modified quality assessment tool, which was previously designed for observational study.The effects of studies were combined with the study quality score using a model of best-evidence synthesis.Results 24 observational studies involving 3789 patients were included.These articles published between 2004 and 2012.According to the quality assessment criteria for included studies, 8 studies were deemed as high quality studies, 6 as moderate quality studies, and 10 as low quality studies.There were strong evidence for 3 risk factors, including lower BMD, lower BMI, intradiscal cement leakage, and vertebral height restoration.We also identified 6 moderate-evidence factors including lower BMI, number of preexisting vertebral fractures, thoracolumbar junction in initial VCFs, cement distraction, older age, and number of treated vertebrae.Thirteen factors were classified into the limited evidence risk factors.Conclusion Whilst there is no conclusive evidence for new VCFs ofpatients with osteoporosis after PVP procedure, these data provide evidence to guide the surgeon and develop optimal preventions for new VCFs after PVP.Special attention should be paid to the 3 strong-evidence risk factors.Further studies were still required to evaluate the effects of all above risk factors.