Department of Interventional Radiology, University Hospital of Strasbourg, 1, place de l'hôpital, 67000, Strasbourg, France.
Medtronic Core Clinical Solution, Milan, Italy.
Eur Radiol. 2021 Nov;31(11):8246-8255. doi: 10.1007/s00330-021-07985-9. Epub 2021 Apr 26.
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).
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.
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).
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.
• 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%.
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。
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。
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)。
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。
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%。