经皮椎体强化术后邻近椎体骨折影响因素的Meta分析

doi:10.3969/j.issn.1006-6233.2024.02.07

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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.

Key words： Osteoporotic vertebral compression fracture Percutaneous vertebral augmentation Meta-analysis Influencing factors

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.02.07 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I2/210

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