Subsequent fractures after vertebroplasty in osteoporotic vertebral fractures: a meta-analysis

Neurosurg Rev. 2022 Jun;45(3):2349-2359. doi: 10.1007/s10143-022-01755-x. Epub 2022 Feb 23.

Abstract

Percutaneous vertebroplasty (VP) provides substantial benefit to patients with painful osteoporotic vertebral compression fractures (OVCF). However, the reoccurrence of vertebral fracture after VP is a major concern. The purpose of this study is to conduct a meta-analysis on the incidence of subsequent fractures after VP in patients with OVCF. PubMed and EMBASE were searched. In addition, we scrutinized the reference list of all relevant articles to supplement the database search. We included original articles reporting on new fracture rates after VP in OVCF patients. Subsequent fracture rates were pooled across studies using a random-effects meta-analysis. Thirty-nine studies with a total of 8047 participants from 12 countries were included in this meta-analysis. Patients' age ranged from 64.2 to 94.6 years (reported by 31 studies). The median follow-up was 21 months (36 studies). Pooled estimate for subsequent fractures after VP was 23.4% (95% CI, 19.8-27.2%; I2 = 93.0%, p < 0.01). New fractures after VP in 54.6% of cases occurred in the vertebral bodies adjacent to the treated vertebra (95% CI, 49.0-60.1%; I2 = 66.0%, p < 0.01). A significant proportion of patients undergoing VP for OVCF experience new fractures after treatment, most of which are developed in the vertebral bodies adjacent to the treated vertebra.

Keywords: Meta-analysis; Osteoporosis; Osteoporotic vertebral compression fracture; Systematic review; Vertebroplasty.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Aged, 80 and over
  • Fractures, Compression* / etiology
  • Fractures, Compression* / surgery
  • Humans
  • Middle Aged
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / surgery
  • Spinal Fractures* / etiology
  • Spinal Fractures* / surgery
  • Spine
  • Treatment Outcome
  • Vertebroplasty* / adverse effects