Jørgensen Hanne H, Andersen Mikkel Ø, Frandsen Tove F, Wickstrøm Line A, Kostic Benjamin, Carreon Leah Y
Spine Centre of Southern Denmark, Lillebaelt Hospital, Kolding, DNK.
Department of Design and Communication, University of Southern Denmark, Kolding, DNK.
Cureus. 2025 May 7;17(5):e83694. doi: 10.7759/cureus.83694. eCollection 2025 May.
Sagittal spinal malalignment is associated with functional disability. Therefore, a key question in treating patients with painful osteoporotic vertebral compression fractures (OVCFs) is whether vertebral augmentation improves sagittal alignment and its associated outcomes. In a systematic literature review based on interventional and observational studies, we evaluated the effect of percutaneous vertebral body augmentation on sagittal alignment and pulmonary function in patients with painful OVCFs. In November 2022 and December 2023, we searched for relevant studies in Medline, Embase, SCOPUS, Web of Science, the Cochrane Central Registry of Controlled Trials, and five trial registries. In total, 15 cohort studies and two non-randomized clinical trials met our inclusion criteria. Participants in these studies had painful OVCFs treated with vertebral body augmentation. Sagittal alignment outcomes from nine articles represented 456 participants with mean ages from 69.3 to 80.8 years, and pulmonary function outcomes from eight articles represented 343 participants with mean ages from 69.1 to 75.7 years. The quality assessment tool for quantitative studies by the Effective Public Health Practice Project assessed the risk of bias (RoB). Mean pre- and postoperative outcome values were calculated for all included studies and those without a high RoB. None of the sagittal alignment parameters improved after vertebral augmentation, and no additional deformity was detected. Vertebral augmentation positively affected pulmonary function, as measured by the percentage of predicted values, and reduced perceived pain levels and functional disability. Data in the included studies were incomplete due to variability in chosen outcomes and follow-up time points. The incomplete data curtailed our data analysis and only allowed cautious conclusions. Variations in study populations and protocols highlight the need for standardized reporting and follow-up in future research.
脊柱矢状面排列不齐与功能障碍相关。因此，在治疗疼痛性骨质疏松性椎体压缩骨折（OVCFs）患者时，一个关键问题是椎体强化是否能改善矢状面排列及其相关结果。在一项基于干预性和观察性研究的系统文献综述中，我们评估了经皮椎体强化对疼痛性OVCFs患者矢状面排列和肺功能的影响。在2022年11月和2023年12月，我们在Medline、Embase、SCOPUS、Web of Science、Cochrane对照试验中央注册库以及五个试验注册库中检索了相关研究。共有15项队列研究和两项非随机临床试验符合我们的纳入标准。这些研究中的参与者均接受了椎体强化治疗的疼痛性OVCFs。来自9篇文章的矢状面排列结果代表了456名参与者，平均年龄在69.3至80.8岁之间，来自8篇文章的肺功能结果代表了343名参与者，平均年龄在69.1至75.7岁之间。有效公共卫生实践项目的定量研究质量评估工具评估了偏倚风险（RoB）。计算了所有纳入研究以及那些无高RoB研究的术前和术后平均结果值。椎体强化后，矢状面排列参数均未改善，也未检测到额外畸形。通过预测值百分比衡量，椎体强化对肺功能有积极影响，并降低了感知疼痛水平和功能障碍。由于所选结果和随访时间点的变异性，纳入研究中的数据不完整。不完整的数据限制了我们的数据分析，仅能得出谨慎的结论。研究人群和方案的差异凸显了未来研究中标准化报告和随访的必要性。
