Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
Pain Physician. 2012 Jul-Aug;15(4):E515-22.
Vertebroplasty and kyphoplasty have recently been used to treat painful osteoporotic compression fractures. Early clinical results have been encouraging, but very little is known about the consequences of augmentation with cement for adjacent, unaugmented levels.
This study performed a systemic review of the studies concerning whether the incidence of subsequent vertebral body fracture after vertebral augmentation therapy would be increased long-term.
A meta-analysis of randomized controlled trials was performed comparing the long-term incidence of subsequent vertebral body fracture between vertebral augmentation surgeries like vertebroplasty and kyphoplasty and conventional nonsurgical management.
The MEDLINE, EMBASE, ISI Web of Science and Cochrane Library databases and abstracts published in annual proceedings were systematically searched for evidence.
Relevant reports were reviewed by 2 reviewers independently and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria.
Pooled results from 2 randomized controlled trials showed no significant increase of the secondary fracture rate after vertebral augmentation therapy compared with that of conventional treatment (P = 0.07). Few large-sample randomized controlled trials were specifically performed to investigate new fractures as an outcome of vertebroplasty or kyphoplasty.
There were few data sources from which to extract abstracted data or published studies. There were only 2 randomized controlled trials that met criteria.
Although vertebral augmentation therapies, such as vertebroplasty and kyphoplasty, have been widely used in clinics to treat patients' back pain caused by vertebral compression fractures due to osteoporosis, no evidence shows that they can increase the fracture of adjacent vertebral bodies.
椎体成形术和后凸成形术最近被用于治疗疼痛性骨质疏松性压缩性骨折。早期的临床结果令人鼓舞，但对于骨水泥增强对相邻未增强水平的影响知之甚少。
本研究对椎体增强治疗后是否会增加随后发生椎体骨折的长期风险进行了系统评价。
对比较椎体成形术和后凸成形术等椎体增强手术与常规非手术治疗的长期后续椎体骨折发生率的随机对照试验进行了荟萃分析。
系统检索了 MEDLINE、EMBASE、ISI Web of Science 和 Cochrane 图书馆数据库以及年度会议的摘要，以寻找证据。
由 2 名评审员独立对相关报告进行了审查，并根据 QUOROM 声明标准，从这些报告的参考文献中搜索了其他试验。
2 项随机对照试验的汇总结果显示，椎体增强治疗后继发性骨折率与常规治疗相比无显著增加（P = 0.07）。很少有大型随机对照试验专门研究新骨折作为椎体成形术或后凸成形术的结果。
从中提取摘要数据或发表研究的数据源很少。符合标准的只有 2 项随机对照试验。
尽管椎体成形术和后凸成形术等椎体增强疗法已广泛应用于临床，以治疗因骨质疏松导致的椎体压缩性骨折引起的背痛，但没有证据表明它们会增加相邻椎体骨折的风险。
