Jun Zou1, Xin Mei, Xuesong Zhu, Qin Shi, Huilin Yang. 1. Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
Abstract
BACKGROUND: Vertebroplasty and kyphoplasty have recently been used to treat painful osteoporotic compression fractures. Early clinical results have been encouraging, but very little is known about the consequences of augmentation with cement for adjacent, unaugmented levels. OBJECTIVE: This study performed a systemic review of the studies concerning whether the incidence of subsequent vertebral body fracture after vertebral augmentation therapy would be increased long-term. STUDY DESIGN: A meta-analysis of randomized controlled trials was performed comparing the long-term incidence of subsequent vertebral body fracture between vertebral augmentation surgeries like vertebroplasty and kyphoplasty and conventional nonsurgical management. SETTING: The MEDLINE, EMBASE, ISI Web of Science and Cochrane Library databases and abstracts published in annual proceedings were systematically searched for evidence. METHODS: Relevant reports were reviewed by 2 reviewers independently and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. RESULTS: Pooled results from 2 randomized controlled trials showed no significant increase of the secondary fracture rate after vertebral augmentation therapy compared with that of conventional treatment (P = 0.07). Few large-sample randomized controlled trials were specifically performed to investigate new fractures as an outcome of vertebroplasty or kyphoplasty. LIMITATIONS: There were few data sources from which to extract abstracted data or published studies. There were only 2 randomized controlled trials that met criteria. CONCLUSIONS: Although vertebral augmentation therapies, such as vertebroplasty and kyphoplasty, have been widely used in clinics to treat patients' back pain caused by vertebral compression fractures due to osteoporosis, no evidence shows that they can increase the fracture of adjacent vertebral bodies.
BACKGROUND: Vertebroplasty and kyphoplasty have recently been used to treat painful osteoporotic compression fractures. Early clinical results have been encouraging, but very little is known about the consequences of augmentation with cement for adjacent, unaugmented levels. OBJECTIVE: This study performed a systemic review of the studies concerning whether the incidence of subsequent vertebral body fracture after vertebral augmentation therapy would be increased long-term. STUDY DESIGN: A meta-analysis of randomized controlled trials was performed comparing the long-term incidence of subsequent vertebral body fracture between vertebral augmentation surgeries like vertebroplasty and kyphoplasty and conventional nonsurgical management. SETTING: The MEDLINE, EMBASE, ISI Web of Science and Cochrane Library databases and abstracts published in annual proceedings were systematically searched for evidence. METHODS: Relevant reports were reviewed by 2 reviewers independently and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. RESULTS: Pooled results from 2 randomized controlled trials showed no significant increase of the secondary fracture rate after vertebral augmentation therapy compared with that of conventional treatment (P = 0.07). Few large-sample randomized controlled trials were specifically performed to investigate new fractures as an outcome of vertebroplasty or kyphoplasty. LIMITATIONS: There were few data sources from which to extract abstracted data or published studies. There were only 2 randomized controlled trials that met criteria. CONCLUSIONS: Although vertebral augmentation therapies, such as vertebroplasty and kyphoplasty, have been widely used in clinics to treat patients' back pain caused by vertebral compression fractures due to osteoporosis, no evidence shows that they can increase the fracture of adjacent vertebral bodies.
Authors: S L Han; S L Wan; Q T Li; D T Xu; H M Zang; N J Chen; L Y Chen; W P Zhang; C Luan; F Yang; Z W Xu Journal: Osteoporos Int Date: 2014-08-23 Impact factor: 4.507
Authors: Anica Eschler; Paula Roepenack; Jan Roesner; Philipp Karl Ewald Herlyn; Heiner Martin; Martin Reichel; Robert Rotter; Brigitte Vollmar; Thomas Mittlmeier; Georg Gradl Journal: Biomed Res Int Date: 2016-02-25 Impact factor: 3.411
Authors: Jan Van Meirhaeghe; Leonard Bastian; Steven Boonen; Jonas Ranstam; John B Tillman; Douglas Wardlaw Journal: Spine (Phila Pa 1976) Date: 2013-05-20 Impact factor: 3.468