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椎体增强术可降低骨质疏松性椎体压缩性骨折患者 12 个月的死亡率和发病率。

Vertebral augmentation reduces the 12-month mortality and morbidity in patients with osteoporotic vertebral compression fractures.

机构信息

Department of Interventional Radiology, University Hospital of Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France.

Medtronic Core Clinical Solution, Milan, Italy.

出版信息

Eur Radiol. 2021 Nov;31(11):8246-8255. doi: 10.1007/s00330-021-07985-9. Epub 2021 Apr 26.

Abstract

OBJECTIVES

To investigate the 12-month all-cause mortality and morbidity in patients with osteoporotic vertebral compression fractures (OVCFs) undergoing vertebroplasty/balloon kyphoplasty (VP/BKP) versus non-surgical management (NSM).

METHODS

Following a Medline and EMBASE search for English language articles published from 2010 to 2019, 19 studies reporting on mortality and morbidity after VP/BKP in patients with OVCFs were selected. The 12-month timeline was set due to the largest amount of data availability at such time interval. Estimates for each study were reported as odds ratios (OR) along with 95% confidence intervals (CI) and p values. Fixed or random-effects meta-analyses were performed. All tests were based on a two-sided significance level of 0.05.

RESULTS

Pooled OR across 5 studies favored VP/BKP over NSM in terms of 12-month all-cause mortality (OR: 0.81 [95% CI: 0.46-1.42]; p = .46). Pooled OR across 11 studies favored VP/BKP over NSM in terms of 12-month all-cause morbidity (OR: 0.64 [95% CI: 0.31-1.30]; p = .25). Sub-analysis of data dealing with 12-month infective morbidity from any origin confirmed the benefit of VP/BKP over NSM (OR: 0.23 [95% CI, 0.02-2.54]; p = .23).

CONCLUSION

Compared to NSM, VP/BKP reduces the 12-month risk of all-cause mortality and morbidity by 19% and 36%, respectively. Moreover, VP/BKP reduces by 77% the 12-month risk of infection from any origin.

KEY POINTS

• Compared to non-surgical management, vertebral augmentation reduces the 12-month risk of all-cause mortality by 19% and all-cause morbidity by 36%. • Vertebral augmentation reduces the 12-month risk of infection morbidity from any origin by 77%.

摘要

目的

研究骨质疏松性椎体压缩性骨折(OVCF)患者行经皮椎体成形术/球囊扩张椎体后凸成形术(VP/BKP)与非手术治疗(NSM)后 12 个月的全因死亡率和发病率。

方法

通过 Medline 和 EMBASE 搜索 2010 年至 2019 年发表的英文文献,选择了 19 项关于 OVCF 患者 VP/BKP 后死亡率和发病率的研究。选择 12 个月的时间线是因为在此时间间隔内可获得最大的数据量。每个研究的估计值均以比值比(OR)以及 95%置信区间(CI)和 p 值报告。进行固定或随机效应荟萃分析。所有检验均基于双侧显著性水平 0.05。

结果

荟萃分析 5 项研究的结果表明,在 12 个月的全因死亡率方面,VP/BKP 优于 NSM(OR:0.81 [95%CI:0.46-1.42];p =.46)。荟萃分析 11 项研究的结果表明,在 12 个月的全因发病率方面,VP/BKP 优于 NSM(OR:0.64 [95%CI:0.31-1.30];p =.25)。对涉及任何来源的 12 个月感染发病率数据的亚分析证实,VP/BKP 优于 NSM(OR:0.23 [95%CI,0.02-2.54];p =.23)。

结论

与 NSM 相比,VP/BKP 分别降低了 12 个月全因死亡率和发病率的 19%和 36%。此外,VP/BKP 降低了 77%的任何来源感染的 12 个月发病风险。

关键点

  • 与非手术治疗相比,椎体增强降低了 12 个月全因死亡率 19%和全因发病率 36%。

  • 椎体增强降低了任何来源感染发病率的 12 个月风险 77%。

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