Department of Orthopedic Surgery, the Key Laboratory of Digital Orthopaedics of Yunnan Province, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, No. 157 Jinbi Road, Xishan District, Kunming City, 650034, Yunnan Province, China.
The Key Laboratory of Digital Orthopedics of Yunnan Province, No. 157 Jinbi Road, Xishan District, Kunming City, 650034, Yunnan Province, China.
Eur Spine J. 2024 Dec;33(12):4521-4537. doi: 10.1007/s00586-024-08426-z. Epub 2024 Aug 6.
Osteoporotic vertebral compression fracture (OVCF) is a common consequence of osteoporosis and can significantly impact the quality of life for affected individuals. Despite treatment options such as vertebroplasty and kyphoplasty, many patients continue to experience residual back pain (RBP) even after the fracture has healed. The incidence of RBP after OVCF treatment varies among studies, and there is a need for further research to understand the risk factors associated with RBP.
A systematic review and meta-analysis were conducted following the PRISMA guidelines. Electronic databases were searched, and relevant studies were selected based on inclusion and exclusion criteria. Data extraction and quality assessment were performed independently by two authors. Statistical analysis included single-proportion meta-analyses and pooling of odds ratios (OR) using the inverse-variance method, to calculate the overall incidences of RBP and cement leakage and identify risk factors associated with RBP.
A total of 19 studies were included in the analysis. The overall incidences of RBP and cement leakage were found to be 16% and 18%, respectively. Several risk factors were identified, including gender, bone mineral density, depression, baseline visual analog scale (VAS) score, intravertebral vacuum cleft, number of fractured segments, cement distribution, history of vertebral fracture, thoracolumbar fascial injury, and fracture non-union.
This study provides potential value within the scope of the incidence and risk factors of RBP following treatment of OVCFs. The identified risk factors can help clinicians identify high-risk patients and tailor appropriate interventions. Future research should focus on standardizing the definition of RBP and patient selection criteria to improve the accuracy of estimates and facilitate better management strategies for OVCF patients.
骨质疏松性椎体压缩性骨折（OVCF）是骨质疏松症的常见后果，会显著影响受影响个体的生活质量。尽管有椎体成形术和后凸成形术等治疗选择，但许多患者在骨折愈合后仍会持续出现残余背痛（RBP）。OVCF 治疗后 RBP 的发生率在不同研究中有所不同，需要进一步研究以了解与 RBP 相关的风险因素。
按照 PRISMA 指南进行系统评价和荟萃分析。通过电子数据库进行搜索，并根据纳入和排除标准选择相关研究。两位作者独立进行数据提取和质量评估。统计分析包括单比例荟萃分析和使用Inverse-Variance 方法汇总比值比（OR），以计算 RBP 和水泥渗漏的总体发生率，并确定与 RBP 相关的风险因素。
共有 19 项研究纳入分析。RBP 和水泥渗漏的总体发生率分别为 16%和 18%。确定了几个风险因素，包括性别、骨密度、抑郁、基线视觉模拟量表（VAS）评分、椎体内真空裂隙、骨折节段数、水泥分布、椎体骨折史、胸腰椎筋膜损伤和骨折不愈合。
本研究在 OVCF 治疗后 RBP 的发生率和风险因素范围内提供了潜在价值。确定的风险因素可以帮助临床医生识别高危患者，并制定适当的干预措施。未来的研究应侧重于标准化 RBP 的定义和患者选择标准，以提高估计的准确性，并为 OVCF 患者提供更好的管理策略。
