背景:经皮椎体成形术(PVP)或经皮椎体后凸成形术(PKP)后夹心椎骨(SDV)的形成已成为普遍现象。SDV是否更容易骨折仍有争议。因此,我们进行了一项荟萃分析,以提供医学证据,证明在PVP或PKP后,SDV是否比非SDV(NSDV)更容易再骨折.
方法:本研究按照系统评价和荟萃分析的优选报告项目标准进行。几个数据库,包括PubMed,Embase,Medline数据库,中国国家知识基础设施,万方,和维普,从任何时间点直到2022年6月都被彻底搜索相关研究。使用Revman5.4进行统计分析。
结果:共纳入9项研究的4052名个体。总的来说,SDV患者再骨折的风险高于NSDV患者(OR=1.57,P=0.04).在随访时间少于3年的研究中,两组之间的再骨折发生率相当(OR=1.28,P=0.49)。然而,在随访时间超过3年的研究中,SDV患者比NSDV患者更容易发生再骨折(OR=1.92,P=0.009).此外,在同时涉及PVP和PKP的研究中,SDV患者比NSDV患者更容易再骨折(OR=1.62,P=0.002).此外,年龄,骨密度低,夹心骨折节段后凸角度>10°是预测再骨折的独立因素。
结论:患有SDV的患者更有可能在PVP或PKP后再骨折,特别是当随访时间超过3年时。
方法:
BACKGROUND: The formation of sandwiched vertebrae (SDVs) after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) has become a common phenomenon. Whether SDVs are more likely to fracture is still controversial. Therefore, we conducted a meta-analysis to provide medical evidence for whether SDVs are more prone to
refracture than non-SDVs (NSDVs) after PVP or PKP.
METHODS: This study was conducted in accordance with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Several databases, including PubMed, Embase, Medline databases, China National Knowledge Infrastructure, Wanfang, and Weipu, were thoroughly searched for relevant studies included from any point up until June 2022. Statistical analyses were performed using Revman 5.4.
RESULTS: A total of 4052 individuals from 9 studies were enrolled. Overall, patients with SDV presented more risk to have
refracture than patients with NSDV (OR = 1.57, P = 0.04). The incidences of
refracture were comparable between the 2 cohorts in studies with a follow-up time less than 3 years (OR = 1.28, P = 0.49). However, patients with SDV were more prone to have
refracture than patients with NSDV in studies with a follow-up time longer than 3 years (OR = 1.92, P = 0.009). Moreover, patients with SDV were more likely to have
refracture than patients with NSDV in studies that involved both PVP and PKP (OR = 1.62, P = 0.002). In addition, age, low bone density, and postoperative kyphosis angle of sandwich fracture segments >10° were independent factors to predict refracture.
CONCLUSIONS: Patients with SDV were more likely to have refracture after PVP or PKP, especially when the follow-up time was longer than 3 years.
METHODS: