Clinic for Orthopaedic, Trauma and Plastic Surgery, Department of Spine Surgery, University Hospital Leipzig, Liebigstr. 20, D-04103, Leipzig, Germany.
Eur Spine J. 2024 Aug;33(8):3213-3220. doi: 10.1007/s00586-024-08403-6. Epub 2024 Jul 17.
Systematic review.
Osteoporotic vertebral fractures (OVFs) and degenerative spine conditions are age-related and associated with higher morbidity and mortality and greater health care costs. The relationship between OVFs and prevalent spine degeneration is rarely reported. The aim of this study was to systematically review current literature on the influence of preexisting degenerative spine conditions in patients with OVFs on the occurrence of complications during and after treatment.
A systematic literature review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed using Web of Science and MEDLINE. We considered English and German articles published from January 1990 to December 2022. The inclusion criteria were patients with OVFs and preexisting spinal degeneration with complications such as subsequent fractures, deformity, implant failure and surgical and general complications. The included studies were controlled trials, cohort studies, and case series.
Ten articles met the inclusion criteria (two prospective studies, seven retrospective studies and one case series). These were divided into two groups: studies on OVFs in patients with coexisting degenerative spine conditions (n = 5) and studies on OVFs following surgical treatment for degenerative spine conditions (n = 5). Three studies reported more complications in patients with OVFs and severe degeneration. One study stated the opposite. One study did not find any correlation. The remaining studies described complications narratively. Subsequent fractures were the most frequent complications.
OVFs in patients with preexisting spinal degeneration seem to cause more complications. In addition to subsequent fractures, other complications have rarely been examined. The presence of degenerative changes or undergoing surgical correction may increase the risk of subsequent fractures.
系统评价。
骨质疏松性椎体骨折（OVFs）和退行性脊柱疾病与年龄相关，与更高的发病率和死亡率以及更高的医疗保健成本相关。OVFs 与普遍存在的脊柱退行性变之间的关系很少有报道。本研究旨在系统回顾目前关于 OVFs 患者中存在的退行性脊柱疾病对治疗过程中和治疗后并发症发生的影响的文献。
我们按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，使用 Web of Science 和 MEDLINE 进行了系统的文献回顾。我们考虑了 1990 年 1 月至 2022 年 12 月发表的英语和德语文章。纳入标准为患有 OVFs 和先前存在的脊柱退行性变的患者，伴有并发症，如随后的骨折、畸形、植入物失败以及手术和一般并发症。纳入的研究为对照试验、队列研究和病例系列研究。
符合纳入标准的有 10 篇文章（2 项前瞻性研究、7 项回顾性研究和 1 项病例系列研究）。这些文章分为两组：一组是合并退行性脊柱疾病的 OVFs 患者的研究（n=5），另一组是退行性脊柱疾病手术后 OVFs 的研究（n=5）。有 3 项研究报告称，退行性病变严重的 OVFs 患者有更多并发症。有 1 项研究则持相反的观点。有 1 项研究未发现任何相关性。其余研究则进行了叙述性描述。随后的骨折是最常见的并发症。
患有先前存在的脊柱退行性变的 OVFs 患者似乎会引起更多的并发症。除了随后的骨折，其他并发症很少被检查。退行性改变的存在或接受手术矫正可能会增加随后骨折的风险。
