Abstract：Objective: To analyze the related factors of adjacent vertebral fractures after percutaneous vertebral augmentation (PVA) in patients with osteoporosis vertebral compression fracture (OVCF) by a systematic review. Methods: Databases including PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang Data Knowledge Service platform, Vip.com, and Chinese biomedical literature database, were searched to screen relevant studies on influencing factors of adjacent vertebral fractures after PVA in patients with OVCF. The search period extended from the establishment of each database to May 21, 2023. Meta-analysis was performed using RevMan 5.4 and Stata 17. Results: Finally, 43 case-control studies were included, all of which were high quality literatures, with a total sample size of 10601 cases. Meta-analysis results showed that risk factors for adjacent vertebral fractures after PVA included advanced age[OR=1.13, 95%CI (1.08,1.17)], low body mass index [OR=2.29, 95% CI (1.36, 3.84)], smoking [OR=2.77, 95% CI (1.52, 5.05)], low bone mineral density [OR= 3.88, 95% CI (2.64, 5.70)], diabetes [OR=2.25, 95%CI (1.57, 3.21)], scoliosis [OR=4.41, 95% CI (2.52, 7.73)], more injured vertebra [OR=2.02,95%CI(1.43, 2.85)], bone cement leakage [OR=3.47, 95% CI (2.77, 4.35)], excessive injection of bone cement [OR=2.94, 95% CI (2.50, 3.46)], high recovery rate of vertebral body height [OR=1.28, 95% CI (1.10, 1.49)], excessive correction of local Cobb Angle [OR=1.27, 95% CI (1.04, 1.55)]; The protective factor was anti-osteoporosis therapy [OR=0.32, 95% CI (0.21, 0.49)]. Conclusion: Advanced age, low body mass index, smoking, low bone mineral density, chronic obstructive pulmonary disease, diabetes, scoliosis, more injured vertebra, bone cement leakage, excessive injection of bone cement, high recovery rate of vertebral height, and excessive correction of local Cobb Angle are risk factors for adjacent vertebral fractures after PVA. In clinical practice, the controllable risk factors should be actively controlled, and a reasonable anti-osteoporosis treatment program should be formulated to reduce the adverse prognosis. The conclusions drawn above still require further validation through more large-scale and high-quality studies.
[1] Salari N, Ghasemi H, Mohammadi L, et al. The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis[J].Orthop Surg Res, 2021,16(1):609. [2] 马远征, 王以朋, 刘强, 等. 中国老年骨质疏松症诊疗指南(2018)[J]. 中国骨质疏松杂志,2018,12:1541-1567. [3] Kado D M, Duong T, Stone K L, et al. Incident vertebral fractures and mortality in older women: a prospective study[J]. Osteoporosis Int, 2003,14(7):589-594. [4] Johnston CB, Dagar M. Osteoporosis in older adults[J]. Med Clin North Am, 2020,104(5):873-884. [5] Hoyt D, Urits I, Orhurhu V, et al. Current concepts in the management of vertebral compression fractures[J].Curr Pain Headache Rep, 2020,24(5):16. [6] Guo JB, Zhu Y, Chen BL, et al. Surgical versus non-surgical treatment for vertebral compression fracture with osteopenia: a systematic review and meta-analysis[J]. Plos One, 2015,10(5):e0127145. [7] Cazzato RL, Bellone T, Scardapane M, et al. Vertebral augmentation reduces the 12-month mortality and morbidity in patients with OVCFs[J]. Eur Radiol, 2021,31(11):8246-8255. [8] Zhang B, Li T, Wang Z. Efficacy and complications of different surgical modalities of treating osteoporotic spinal compression fracture in the elderly[J]. Am Trans Res, 2022,14(1):364-372. [9] Li H, Yang DL, Ma L, et al. Risk factors associated with adjacent vertebral compression fracture following percutaneous vertebroplasty after menopause: a retrospective study[J]. Med Sci Monit, 2017,(23):5271-5276. [10] Takahara K, Kamimura M, Moriya H, et al. Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women[J]. BMC Musculoskelet Disord, 2016,(17):12. [11] 童奕博,李明辉.骨质疏松性椎体骨折患者椎体成形后邻近椎体再发骨折的影响因素[J].中国组织工程研究,2024,28(8):1241-1246. [12] 姜天淇,葛泽峰,田新月,等. 骨质疏松性椎体压缩骨折经皮椎体成形术后继发椎体再骨折的相关因素分析[J]. 脊柱外科杂志,2023,(1):21-25. [13] 侯立松,王娜娜. 骨质疏松性胸腰椎骨折PVP术后邻近椎体骨折危险因素分析[J]. 中国烧伤创疡杂志,2021,(3):221-224. [14] 张子龙,井齐明,乔瑞,等. 骨质疏松性椎体压缩骨折经皮椎体成形术后邻近椎体骨折的危险因素分析[J]. 中国修复重建外科杂志,2021,(1):20-25. [15] 王强,张骏,王天,等. 经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床疗效及术后邻近椎体骨折的危险因素分析[J]. 现代生物医学进展,2021,(21):4095-4099. [16] 王俊峰,樊盛,刘伟峰. 绝经后女性患者行PVP术后继发相邻椎体骨折的危险因素分析[J]. 颈腰痛杂志,2020,(2):185-188. [17] 吴伟峰,胡超,葛永军,等. 骨质疏松性椎体压缩骨折经皮椎体成形术术后邻近椎体骨折的危险因素[J]. 临床骨科杂志,2020,(5):614-617. [18] 崔艳玲. 中老年妇女骨质疏松性胸腰椎骨折术后邻近椎体骨折的危险因素分析[J]. 中国妇幼保健,2020,(14):2695-2698. [19] 吴俊涛,张春旺,卢绪章. 经皮椎体成形术中伤椎高度矫正情况与术后再发邻椎骨折的相关性分析[J]. 颈腰痛杂志,2020,(5):617-619. [20] 韩晓东,孟纯阳. PVP术后椎体前缘高度恢复率与邻近椎体骨折的相关性研究[J]. 中国矫形外科杂志,2019,(10):885-889. [21] 刘伟. 经皮椎体成形术治疗骨质疏松性胸腰段脊柱骨折后邻近椎体骨折的危险因素分析[J]. 解放军医药杂志,2017,(12):53-56. [22] 侯文根,孙晓辉,张超,等. 老年椎体压缩性骨折患者经皮椎体成形术后邻近椎体骨折的发生率及相关危险因素分析[J]. 中国矫形外科杂志,2016,(20):1909-1911. [23] 余鹏,夏群,皮红林,等. 经皮椎体成形术后相邻椎体再骨折的相关因素[J]. 中华创伤杂志,2013,(11):1063-1067. [24] Morozumi M, Matsubara Y, Muramoto A, et al. A study of risk factors for early-onset adjacent vertebral fractures after kyphoplasty[J]. Global Spine, 2020,10(1):13-20. [25] 栾昊鹏,邓强,帕尔哈提·热西提,等. 经皮椎体后凸成形术后邻近椎体继发骨折的危险因素分析[J]. 中国骨与关节杂志,2022,(4):269-275. [26] 黄永恒,刘星,尚显文. 骨质疏松性椎体压缩骨折患者PKP治疗后发生邻近椎体骨折的危险因素分析[J]. 山东医药,2021,(23):72-76. [27] 吴斌,白峰华,林明侠,等. 骨水泥注射椎体后凸成形对老年妇女邻近椎体塌陷影响的风险评估[J]. 中国组织工程研究,2020,(12):1829-1834. [28] 康兵文,肖波,赵明,等. 单节段胸腰段骨质疏松性椎体压缩骨折患者PKP术后临近椎体骨折的危险因素分析[J]. 颈腰痛杂志,2019,(2):242-243. [29] 杨波,王庆雷,马建华,等. 两种术式治疗老年骨质疏松性椎体压缩骨折的效果及其术后继发相邻椎体骨折的危险因素分析[J]. 首都医科大学学报,2021,(2):293-298. [30] 陈涛,杨建东,张亮,等. 骨质疏松性胸腰椎骨折椎体强化术后发生邻近椎体骨折的危险因素分析[J]. 骨科,2017,(3):190-193,199. [31] 孙思鑫,朱志军,孔德群,等. 骨质疏松性椎体压缩骨折患者PVA术后继发邻椎骨折的多因素分析[J]. 海南医学,2021,(23):3109-3111. [32] 陈建常,王鑫,马在松,等. 骨质疏松患者PVP/PKP术后新发椎体压缩性骨折相关危险因素[J]. 中国矫形外科杂志,2015,(10):902-907. [33] Wang YT, Wu XT, Chen H, et al. Adjacent-level symptomatic fracture after percutaneous vertebral augmentation of OVCF: a retrospective analysis[J].Orthop Sci, 2014,19(6):868-876. [34] 胡浩,曹开学,黄攀,等. 超高龄骨质疏松性胸腰椎压缩骨折经皮椎体成形术术后邻椎再骨折的危险因素分析[J]. 中国骨伤,2022,(8):710-714. [35] 陈善堂. 老年骨质疏松性椎体压缩骨折椎体成形术术后继发骨折的影响因素[J]. 中国老年学杂志,2020,(8):1654-1657. [36] 陈新来,于志勇,黄春选,等. 球囊扩张椎体后凸成形术后继发相邻节段椎体骨折的危险因素分析[J]. 中国骨与关节损伤杂志,2016,(1):37-39. [37] 张斌,尚咏. 经皮椎体后凸成形术后继发邻近椎体骨折的危险因素分析[J]. 临床骨科杂志,2014,(3):249-252. [38] 刘军,张陆,刘志昂,等. 经皮椎体增强术后邻近椎体骨折的相关因素[J]. 中国矫形外科杂志,2020,(4):319-322. [39] Chen C, Fan P, Xie X, Wang Y. Risk factors for cement leakage and adjacent vertebral fractures in kyphoplasty for osteoporotic vertebral fractures[J]. Clin Spine Surg, 2020, 33(6):251-255. [40] 刘壮,王元利,闫志刚,等. 椎体成形术后相邻椎体骨折的发生率与影响因素分析[J]. 河北医药,2022,(4):588-590. [41] 张鹭,吴军,路锟,等. 经皮椎体成形术治疗老年骨质疏松椎体压缩性骨折术后邻近椎体骨折的相关危险因素[J]. 中国老年学杂志,2015,(16):4612-4614. [42] Spross C, Aghayev E, Kocher R, et al. Incidence and risk factors for this early adjacent vertebral fractures after balloon kyphoplasty for osteoporotic fractures: analysis of the SWISSspine registry[J]. Eur Spine, 2014,23(6):1332-1338. [43] 方申雲,闵继康,曾忠友,等. 经皮穿刺椎体扩张球囊后凸成形术后邻近椎体骨折相关危险因素分析[J]. 中国骨伤,2021,(8):705-709. [44] 余俊喜,吴少坚,刘燕群,等. 骨水泥分布状况与骨质疏松性椎体压缩骨折术后再发邻近骨折的关系[J]. 中国临床医生杂志,2020,(4):466-468. [45] 安忠诚,陈晨,董黎强,等. 经皮椎体后凸成形术后邻近节段再骨折的危险因素分析[J]. 中华全科医学,2022,(4):591-593,712. [46] Cheng Y, Yang Y, Hai Y, et al. Low paraspinal lean muscle mass is an independent predictor of adjacent vertebral compression fractures after percutaneous kyphoplasty: a propensity score-matched case-control study[J]. Front Surg, 2022,(9):965332. [47] 谢碧燕,陈小燕. 单节段OVCF患者经PKP术后邻近椎体骨折影响因素分析[J]. 中外医学研究,2022,(22):173-176. [48] 胡丽丹,胡敏,周鹃,等. PKP术后邻近椎体骨折的相关因素分析[J]. 中国骨与关节损伤杂志,2020,(1):54-56. [49] 丁小力,王燕,闫海珠,等. 椎体成形术后邻椎新发骨折特征与相关因素分析[J]. 宁夏医学杂志,2018,(12):1193-1195. [50] Movrin I, Vengust R, Komadina R. Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a comparison of balloon kyphoplasty and vertebroplasty[J]. Arch Orthop Trauma Surg, 2010,130(9):1157-1166. [51] Rho YJ, Choe WJ, Chun YI. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty[J]. Eur Spine, 2012,21(5):905-911. [52] Reinehr T, Roth CL. A new link between skeleton, obesity and insulin resistance: relationships between osteocalcin, leptin and insulin resistance in obese children before and after weight loss[J]. Int Obes (Lond), 2010,34(5):852-858.
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