Risk factors of cemented vertebral refracture after percutaneous vertebral augmentation: a systematic review and meta-an
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REVIEW
Risk factors of cemented vertebral refracture after percutaneous vertebral augmentation: a systematic review and meta-analysis Shiqi Zhu 1 & Qingjun Su 1 & Yaoshen Zhang 1 & Zhencheng Sun 1 & Peng Yin 1 & Yong Hai 1 Received: 24 March 2020 / Accepted: 8 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract To evaluate the risk factors of cemented vertebral refracture after percutaneous vertebral augmentation (PVA) for patients with osteoporotic vertebral compression fractures (OVCFs). We performed a literature search on cemented vertebral refracture after PVA using the PubMed, EMBASE, and Cochrane Library medical databases. The clinical data, including literature information, basic patient information, observational factors, and interventional factors, were extracted by two authors. The pooled results and related heterogeneity of each factor between the refracture group and the non-refracture group were evaluated using Review Manager software 5.35. A total of 3185 patients from 10 studies were included, with 195 patients in the refracture group and 2990 patients in the nonrefracture group. The mean follow-up duration was 18.9 months. According to the meta-analysis, age, low bone marrow density (BMD), intravertebral cleft (IVC), high anterior vertebral height (AVH) restoration/high Cobb angle restoration, and low cement dose were the risk factors of cemented vertebral refracture after PVA. Our results showed that age, low BMD, IVC, high AVH restoration, high Cobb angle restoration, and low cement dose were the risk factors for cemented vertebral refracture after PVA. Keywords Percutaneous vertebral augmentation . Osteoporotic vertebral compression fracture . Refracture . Risk factor . Meta-analysis
Introduction Vertebral fractures include traumatic vertebral burst fractures, pathologic fractures, and osteoporotic vertebral compression fractures (OVCFs); OVCFs are the most commonly noted vertebral fractures. Among the population aged > 50 years in Asia, 25.3% of the individuals experienced OVCFs [1]. Although several patients could be cured using conservative treatment, long-term clinotherapy usually leads to complications, such as bedsores, pneumonia, and even death [2]. Hence, minimally invasive spine surgery has gradually become the primary treatment for improving the quality of the life after OVCFs. Percutaneous vertebral augmentation (PVA), including percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) is the primary treatment for OVCFs, and the majority of researchers believe that * Peng Yin [email protected]
PVA is effective for alleviating the pain caused by OVCFs [3]. Nevertheless, some complications are associated with PVA. A previous study reported that patients with a history of PVA surgery experienced refractures after only a few months [4]. Several studies have reported on the risk factors of vertebral refracture after PVA [5]. However, the refractured vertebrae were not analyzed separately as cemented vertebrae, adjacent vertebrae, and far vertebra
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