Clinical and radiological subsequent fractures after vertebral augmentation for treating osteoporotic vertebral compress
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ORIGINAL ARTICLE
Clinical and radiological subsequent fractures after vertebral augmentation for treating osteoporotic vertebral compression fractures: a meta‑analysis Hai‑Bo Sun1 · Xiao‑Shan Jing2 · Hai Tang1 · Yong Hai3 · Jin‑Jun Li1 · Jian‑Lin Shan1 · De‑Cheng Wang4 Received: 3 June 2020 / Accepted: 2 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose 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. Methods 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. Results 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. Conclusion 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. Keywords Osteoporotic vertebral compression fracture · Percutaneous vertebral augmentation · Vertebroplasty · Kyphoplasty · Conservative treatment · Subsequent fracture · Meta-analysis
Hai-Bo Sun and Xiao-Shan Jing contributed equally to this work and should be considered co-first authors. * Hai‑Bo Sun [email protected] Xiao‑Shan Jing [email protected] Hai Tang [email protected] Yong Hai [email protected]
1
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University (Capital Medical University Second Clinical Medical University), No. 95, Yong’an Road, Xicheng District, Beijing 100050, China
2
Department of Emergency, Beijing Friendship Hospital, Capital Medical University (Capital Medical University Second Clinical Medical University), No. 95, Yong’an Road, Xicheng District, Beijing 100050, China
3
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University (Capital Medical University Third Clinical Medical University), GongTiNanLu 8#, Chaoyang District, Beijing 100020, China
4
Department of Orthopedics, Beijing
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