Liu Xue-Yang, Feng Min, Zhang Xiang-Long, Zou Tao, Huang Zhi, Yang Jian-Dong, Sun Hui-Hui
Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
Day treatment ward, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
Int J Spine Surg. 2024 Feb 27;18(1):83-90. doi: 10.14444/8577.
The formation of sandwiched vertebrae (SDVs) after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) has become a common phenomenon. Whether SDVs are more likely to fracture is still controversial. Therefore, we conducted a meta-analysis to provide medical evidence for whether SDVs are more prone to refracture than non-SDVs (NSDVs) after PVP or PKP.
This study was conducted in accordance with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Several databases, including PubMed, Embase, Medline databases, China National Knowledge Infrastructure, Wanfang, and Weipu, were thoroughly searched for relevant studies included from any point up until June 2022. Statistical analyses were performed using Revman 5.4.
A total of 4052 individuals from 9 studies were enrolled. Overall, patients with SDV presented more risk to have refracture than patients with NSDV (OR = 1.57, = 0.04). The incidences of refracture were comparable between the 2 cohorts in studies with a follow-up time less than 3 years (OR = 1.28, = 0.49). However, patients with SDV were more prone to have refracture than patients with NSDV in studies with a follow-up time longer than 3 years (OR = 1.92, = 0.009). Moreover, patients with SDV were more likely to have refracture than patients with NSDV in studies that involved both PVP and PKP (OR = 1.62, = 0.002). In addition, age, low bone density, and postoperative kyphosis angle of sandwich fracture segments >10° were independent factors to predict refracture.
Patients with SDV were more likely to have refracture after PVP or PKP, especially when the follow-up time was longer than 3 years.
经皮椎体成形术（PVP）或经皮后凸成形术（PKP）后夹心椎体（SDV）的形成已成为一种常见现象。SDV是否更容易骨折仍存在争议。因此，我们进行了一项荟萃分析，以提供医学证据，证明PVP或PKP后SDV是否比非SDV（NSDV）更容易再次骨折。
本研究按照系统评价和荟萃分析的首选报告项目标准进行。全面检索了多个数据库，包括PubMed、Embase、Medline数据库、中国知网、万方和维普，以查找截至2022年6月的任何相关研究。使用Revman 5.4进行统计分析。
共纳入9项研究中的4052名个体。总体而言，SDV患者比NSDV患者发生再次骨折的风险更高（OR = 1.57，P = 0.04）。在随访时间少于3年的研究中，两组的骨折发生率相当（OR = 1.28，P = 0.49）。然而，在随访时间超过3年的研究中，SDV患者比NSDV患者更容易发生再次骨折（OR = 1.92，P = 0.009）。此外，在涉及PVP和PKP的研究中，SDV患者比NSDV患者更有可能发生再次骨折（OR = 1.62，P = 0.002）。此外，年龄、低骨密度以及夹心骨折节段的术后后凸角度>10°是预测再次骨折的独立因素。
PVP或PKP后，SDV患者更有可能发生再次骨折，尤其是随访时间超过3年时。
