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Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis
Author(s) -
Cao Junming,
Kong Lingde,
Meng Fantao,
Zhang Yingze,
Shen Yong
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13428
Subject(s) - medicine , odds ratio , meta analysis , cochrane library , bone mineral , confidence interval , bone cement , kyphosis , surgery , osteoporosis , cement , radiography , archaeology , history
Background The risk factors for new vertebral compression fractures ( VCFs ) after vertebroplasty are unclear. The aim of this meta‐analysis was to identify potential risk factors. Methods A systematic electronic literature search was performed using the following databases: PubMed, Embase and Cochrane Library; the databases were searched from the earliest available records in 1966 to May 2015. Pooled odds ratios ( ORs ) or standardized mean differences ( SMDs ) with 95% confidence intervals ( CIs ) were calculated using random‐ or fixed‐effects models. The Newcastle–Ottawa scale was used to evaluate the methodological quality of the studies, and Stata 11.0 was used to analyse the data. Results The primary factors that were associated with new fractures after vertebroplasty were low bone mineral density ( SMD −0.375; 95% CI −0.579 to −0.171), steroid usage ( OR 2.632; 95% CI 1.399 to 4.950) and the presence of multiple treated vertebrae ( OR 2.027; 95% CI 1.442 to 2.851). The data did not support that age, sex, body mass index, non‐steroidal anti‐inflammatory drug usage, vacuum cleft, thoracolumbar junction, cement volume, kyphosis correction, or intradiscal cement leakage could lead to infection after vertebroplasty. Conclusions The present analysis demonstrated that low bone mineral density, the presence of multiple treated vertebrae and a history of steroid usage were associated with the new VCFs after vertebroplasty. Patients with these factors should be informed of the potential increased risk.