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Risk Factors for New Osteoporotic Vertebral Compression Fractures After Vertebroplasty: A Systematic Review and Meta-Analysis.
MedLine Citation:
PMID:  23027362     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY DESIGN:: Literature review and meta-analysis. OBJECTIVE:: To perform a systematic review and meta-analysis of risk factors for new osteoporotic vertebral compression fracture (VCF) after vertebroplasty. SUMMARY OF BACKGROUND DATA:: New osteoporotic VCF is one of the serious complications of vertebroplasty, and it is important to investigate the risk factors for such VCFs. The risk factors for new VCFs reported thus far remain controversial because of limited data and lack of uniform measurements and evaluation. METHODS:: We searched the electronic database of PubMed for case-control studies about the risk of new osteoporotic VCFs after vertebroplasty. RESULTS:: A total of 116 studies were identified, of which 16 studies including 559 cases and 1,736 controls met the inclusion criteria. The significant risk factors for new VCFs were low bone mineral density (BMD; standardized mean difference (SMD): -0.73, 95% confidence interval (CI): -1.26 to -0.20), low body mass index (BMI; SMD: -0.30, 95% CI: -0.51 to -0.10), and intradiscal cement leakage (OR: 2.13, 95% CI: 1.40 to 2.36). The significant risk factors for new VCFs adjacent to the treated VCF were low BMD (SMD: -0.43, 95% CI: -0.76 to -0.09), low BMI (SMD: -0.52, 95% CI: -0.81 to -0.22), and intradiscal cement leakage (OR: 2.61, 95% CI: 1.63 to 4.17). Low BMD, low BMI, intradiscal cement leakage, cement volume, surgical approach, age, sex, and thoracolumbar (T-L) junction fracture were all not significant risk factors for new VCFs away from the original VCF. Only study reported dynamic characteristics as risk factors. CONCLUSIONS:: The results of this meta-analysis strongly suggested that patients with low BMD, low BMI, and intradiscal cement leakage were at high risk for new VCFs after vertebroplasty, and risk-reduction options should be considered for such patients.
Authors:
Zitao Zhang; Jin Fan; Qingfeng Ding; Minjie Wu; Guoyong Yin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-28
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  -     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Spine Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
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