Risk factors for new vertebral compression fractures after vertebroplasty: a meta-analysis

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Abstract

Background:

The risk factors for new vertebral compression fractures (VCFs) after vertebroplasty are unclear. The aim of this meta-analysis was to identify potential risk factors.

Methods:

A systematic electronic literature search was performed using the following databases: PubMed, Embase and Cochrane Library; the databases were searched from the earliest available records in 1966 to May 2015. Pooled odds ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. The Newcastle–Ottawa scale was used to evaluate the methodological quality of the studies, and Stata 11.0 was used to analyse the data.

Results:

The primary factors that were associated with new fractures after vertebroplasty were low bone mineral density (SMD −0.375; 95% CI −0.579 to −0.171), steroid usage (OR 2.632; 95% CI 1.399 to 4.950) and the presence of multiple treated vertebrae (OR 2.027; 95% CI 1.442 to 2.851). The data did not support that age, sex, body mass index, non-steroidal anti-inflammatory drug usage, vacuum cleft, thoracolumbar junction, cement volume, kyphosis correction, or intradiscal cement leakage could lead to infection after vertebroplasty.

Conclusions:

The present analysis demonstrated that low bone mineral density, the presence of multiple treated vertebrae and a history of steroid usage were associated with the new VCFs after vertebroplasty. Patients with these factors should be informed of the potential increased risk.

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