He Lei, Li Wei, Zhai Xingpeng, Li Zhiwei
Shandong Rehabilitation Hospital, Jinan, China.
Jinan Laiwu People's Hospital, Jinan, China.
Eur Spine J. 2025 Jul 14. doi: 10.1007/s00586-025-09111-5.
To systematically evaluate the risk factors of adjacent vertebral re-fracture after percutaneous vertebroplasty and percutaneous kyphoplasty for osteoporotic vertebral compression fractures.
PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM and other databases were searched by computer to collect case-control studies on adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. The retrieval time was from the establishment of the database to July 17,2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using Stata 17.0 software.
A total of 26 articles were included, including 7604 patients. The results of Meta-analysis showed that postoperative bone cement leakage, excessive recovery rate of vertebral height, too little or too much bone cement injection, low bone mineral density, high recovery rate of anterior vertebral height, no anti-osteoporosis treatment after operation, too many injured vertebrae, previous history of fracture, older age and female patients were risk factors for AVCF. High level of bone cement distribution index, physical exercise after operation and low BMI index are protective factors for AVCF.
There are many risk factors for adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. Medical staff should make comprehensive assessment, prevention and intervention.
系统评价经皮椎体成形术和经皮后凸成形术治疗骨质疏松性椎体压缩骨折后相邻椎体再骨折的危险因素。
通过计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CNKI、万方、维普、CBM等数据库，收集关于经皮椎体成形术治疗骨质疏松性椎体压缩骨折后相邻椎体再骨折的病例对照研究。检索时间为各数据库建库至2024年7月17日。由两名研究者独立筛选文献、提取数据并评估纳入研究的偏倚风险。采用Stata 17.0软件进行Meta分析。
共纳入26篇文章，包括7604例患者。Meta分析结果显示，术后骨水泥渗漏、椎体高度恢复率过高、骨水泥注入量过少或过多、骨密度低、椎体前缘高度恢复率高、术后未进行抗骨质疏松治疗、受伤椎体过多、既往骨折史、年龄较大及女性患者是相邻椎体再骨折的危险因素。骨水泥分布指数高、术后进行体育锻炼及BMI指数低是相邻椎体再骨折的保护因素。
经皮椎体成形术治疗骨质疏松性椎体压缩骨折后相邻椎体再骨折的危险因素较多，医护人员应进行综合评估、预防及干预。
