What Are the Risk Factors for Adjacent Vertebral Fracture After Vertebral Augmentation? A Meta-Analysis of Published Studies

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2020 Dec 4

PMID 33272041

Citations 8

Authors

Tianyu Zhang

Yanhua Wang

Peixun Zhang

Feng Xue

Dianying Zhang

Baoguo Jiang

Affiliations

Soon will be listed here.

Abstract

Study Design: Meta-analysis.

Objectives: To provide up-to-date evidence-based outcomes for the incidence and risk factors of adjacent vertebral fracture (AVF) after the vertebral augmentation.

Methods: The MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies assessing the risk factors of adjacent vertebral fracture after vertebral augmentation until June 2020. The AVF incidence and factors potentially affecting AVF were extracted and pooled.

Results: A total of 16 studies, encompassing 2549 patients were included in the meta-analysis. The pooled incidence of AVF was 14% after vertebral augmentation. Female, lower T-score, thoracolumbar junction fracture, intravertebral cleft, more injected cement volume, intradiscal cement leakage significantly increased the risk of AVF. Age, body mass index, steroid medication, Cobb angle change, postoperative Cobb angle showed no significant association with AVF.

Conclusions: Identifying the risk factors of AVF can facilitate prevention strategy to avoid the AVF. Female, T-score, thoracolumbar junction fracture, intravertebral cleft, more cement volume, and intradiscal cement leakage increased the risk of AVF.

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References

Lemke D . Vertebroplasty and kyphoplasty for treatment of painful osteoporotic compression fractures. J Am Acad Nurse Pract. 2005; 17(7):268-76. DOI: 10.1111/j.1745-7599.2005.0045.x. View

Sun G, Tang H, Li M, Liu X, Jin P, Li L . Analysis of risk factors of subsequent fractures after vertebroplasty. Eur Spine J. 2013; 23(6):1339-45. DOI: 10.1007/s00586-013-3110-0. View

Zhang H, Xu C, Zhang T, Gao Z, Zhang T . Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures? A Meta-Analysis. Pain Physician. 2017; 20(1):E13-E28. View

Chen W, Kao Y, Yang S, Yu S, Tu Y, Chung K . Impact of cement leakage into disks on the development of adjacent vertebral compression fractures. J Spinal Disord Tech. 2010; 23(1):35-9. DOI: 10.1097/BSD.0b013e3181981843. View

Li H, Yang D, Ma L, Wang H, Ding W, Yang S . Risk Factors Associated with Adjacent Vertebral Compression Fracture Following Percutaneous Vertebroplasty After Menopause: A Retrospective Study. Med Sci Monit. 2017; 23:5271-5276. PMC: 5685033. DOI: 10.12659/msm.907364. View

Lee D, Park C, Park C, Lee D, Hwang J . Analysis of Risk Factors Causing New Symptomatic Vertebral Compression Fractures After Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures: A 4-year Follow-up. J Spinal Disord Tech. 2013; 28(10):E578-83. DOI: 10.1097/BSD.0000000000000043. View

Strom O, Borgstrom F, Kanis J, Compston J, Cooper C, McCloskey E . Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2012; 6:59-155. DOI: 10.1007/s11657-011-0060-1. View

Yang S, Liu Y, Yang H, Zou J . Risk factors and correlation of secondary adjacent vertebral compression fracture in percutaneous kyphoplasty. Int J Surg. 2016; 36(Pt A):138-142. DOI: 10.1016/j.ijsu.2016.10.030. View

Libicher M, Appelt A, Berger I, Baier M, Meeder P, Grafe I . The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol. 2007; 17(9):2248-52. DOI: 10.1007/s00330-007-0684-0. View

10.

Lee K, Hong S, Lee S, Cha I, Kim B, Kang E . Analysis of adjacent fracture after percutaneous vertebroplasty: does intradiscal cement leakage really increase the risk of adjacent vertebral fracture?. Skeletal Radiol. 2011; 40(12):1537-42. DOI: 10.1007/s00256-011-1139-x. View

11.

Hulme P, Krebs J, Ferguson S, Berlemann U . Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine (Phila Pa 1976). 2006; 31(17):1983-2001. DOI: 10.1097/01.brs.0000229254.89952.6b. View

12.

Takahara K, Kamimura M, Moriya H, Ashizawa R, Koike T, Hidai Y . Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women. BMC Musculoskelet Disord. 2016; 17:12. PMC: 4711009. DOI: 10.1186/s12891-016-0887-0. View

13.

Baroud G, Heini P, Nemes J, Bohner M, Ferguson S, Steffen T . Biomechanical explanation of adjacent fractures following vertebroplasty. Radiology. 2003; 229(2):606-7. DOI: 10.1148/radiol.2292030378. View

14.

Movrin I . Adjacent level fracture after osteoporotic vertebral compression fracture: a nonrandomized prospective study comparing balloon kyphoplasty with conservative therapy. Wien Klin Wochenschr. 2012; 124(9-10):304-11. DOI: 10.1007/s00508-012-0167-4. View

15.

Heo D, Chin D, Yoon Y, Kuh S . Recollapse of previous vertebral compression fracture after percutaneous vertebroplasty. Osteoporos Int. 2008; 20(3):473-80. DOI: 10.1007/s00198-008-0682-3. View

16.

Chen C, Fan P, Xie X, Wang Y . Risk Factors for Cement Leakage and Adjacent Vertebral Fractures in Kyphoplasty for Osteoporotic Vertebral Fractures. Clin Spine Surg. 2020; 33(6):E251-E255. DOI: 10.1097/BSD.0000000000000928. View

17.

Zhang Z, Fan J, Ding Q, Wu M, Yin G . Risk factors for new osteoporotic vertebral compression fractures after vertebroplasty: a systematic review and meta-analysis. J Spinal Disord Tech. 2012; 26(4):E150-7. DOI: 10.1097/BSD.0b013e31827412a5. View

18.

Hu L, Sun H, Wang H, Cai J, Tao Y, Feng X . Cement injection and postoperative vertebral fractures during vertebroplasty. J Orthop Surg Res. 2019; 14(1):228. PMC: 6642552. DOI: 10.1186/s13018-019-1273-z. View

19.

Dong R, Chen L, Tang T, Gu Y, Luo Z, Shi Q . Pain reduction following vertebroplasty and kyphoplasty. Int Orthop. 2012; 37(1):83-7. PMC: 3532655. DOI: 10.1007/s00264-012-1709-0. View

20.

Fan B, Wei Z, Zhou X, Lin W, Ren Y, Li A . Does vertebral augmentation lead to an increasing incidence of adjacent vertebral failure? A systematic review and meta-analysis. Int J Surg. 2016; 36(Pt A):369-376. DOI: 10.1016/j.ijsu.2016.11.082. View