Nguyen Bao Tu Thai, Nguyen Tan Thanh, Kuo Yi-Jie, Chen Yu-Pin
The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Orthopaedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Asian Spine J. 2025 Jun;19(3):476-489. doi: 10.31616/asj.2024.0467. Epub 2025 Mar 4.
Vertebral augmentation is a safe and effective treatment for osteoporotic vertebral compression fractures (OVCFs) in elderly patients. The impact of sarcopenia on post-procedure outcomes has been debated. This meta-analysis examined its effect on outcomes following vertebral augmentation in OVCF patients. Several electronic databases were searched until August 2024 for studies that compared patients with and without sarcopenia after kyphoplasty or vertebroplasty for OVCFs. The outcomes of interest were the rates of vertebral refracture and residual back pain (RBP), clinical outcomes, length of hospital stay, and mortality rate. The pooled results are presented as odds ratios (ORs) or mean differences with corresponding 95% confidence intervals (CIs). Fourteen studies involving 2197 patients with OVCF treated with vertebral augmentation were included. Of these patients, 813 had sarcopenia and 1384 did not, with a mean age of 73.06. Patients with sarcopenia exhibited a higher prevalence of refracture than those without sarcopenia (OR, 2.92; 95% CI, 1.34-6.34; p =0.007). Patients without sarcopenia had a 64% lower risk of RBP than those with sarcopenia (OR, 0.36; 95% CI, 0.23-0.56; p <0.001). Additionally, patients with sarcopenia demonstrated worse postoperative clinical outcomes, longer hospital stays, and a significantly higher risk of mortality. Sarcopenia adversely affects patients undergoing vertebral augmentation for OVCFs. Early diagnosis of sarcopenia in patients with OVCF and the adoption of comprehensive management strategies to improve and maintain muscle health are recommended (PROSPERO registry number: CRD42024578202).
椎体强化术是治疗老年骨质疏松性椎体压缩骨折（OVCFs）的一种安全有效的方法。肌肉减少症对术后结果的影响一直存在争议。这项荟萃分析研究了其对OVCF患者椎体强化术后结果的影响。检索了多个电子数据库，直至2024年8月，以查找比较行椎体后凸成形术或椎体成形术治疗OVCFs后有和没有肌肉减少症患者的研究。感兴趣的结果包括椎体再骨折率和残余背痛（RBP）、临床结果、住院时间和死亡率。汇总结果以比值比（ORs）或平均差及相应的95%置信区间（CIs）表示。纳入了14项研究，共2197例接受椎体强化术治疗的OVCF患者。其中，813例有肌肉减少症，1384例没有，平均年龄为73.06岁。有肌肉减少症的患者再骨折患病率高于无肌肉减少症的患者（OR，2.92；95%CI，1.34 - 6.34；p = 0.007）。无肌肉减少症的患者发生RBP的风险比有肌肉减少症的患者低64%（OR，0.36；95%CI，0.23 - 0.56；p < 0.001）。此外，有肌肉减少症的患者术后临床结果更差，住院时间更长，死亡风险显著更高。肌肉减少症对接受OVCFs椎体强化术的患者有不利影响。建议对OVCF患者早期诊断肌肉减少症，并采用综合管理策略来改善和维持肌肉健康（PROSPERO注册号：CRD42024578202）。
