Risk factors for fractures secondary to percutaneous vertebroplasty for osteoporotic vertebral com-pression fractures: a Meta-analysis

Abstract

Objective To identify the risk factors for the fractures secondary to percutaneous ver-tebroplasty for osteoporotic vertebral compression fractures. Methods A comprehensive search was conducted for the studies from January 2006 to September 2016 on the risk factors for secondary fractures after percutaneous vertebroplasty in the Cochrane Library, PubMed Data, CNKI, Chinese Biomedical Database, Wanfang Data and manually as well. After retrieval of the eligible data, software Revman5.0 was used to perform the heterogeneity test and calculate the pooled odds ratio (OR), weighted mean difference(WMD) value and 95% confidence interval (CI). Results Twenty studies involving 3,602 patients, 627 of whom had fracture secondary to the surgery, were included in this meta-analysis. Meta-analyses showed the secondary fracture after percutaneous vertebroplasty for osteoporotic vertebral compression fracture was related to bone mineral density [WMD=-0.66, 95%CI (-0.97,-0.36), P 0.05], age [WMD=1.48, 95%CI (-0.13, 3.09), P >0.05], body mass index [WMD=-0.76, 95%CI(-1.61, 0.08), P >0.05], cement volume [WMD=-0.15, 95%CI (-0.60, 0.30), P >0.05], intradiscal cement [OR=1.11, 95%CI (0.56, 2.22), P >0.05], number of vertebrae primarily treated [OR=0.74, 95%CI (0.09, 6.45), P >0.05], thoracolumbar spine [OR=0.86, 95%CI (0.63, 1.18), P >0.05], or cement injection approach [OR=1.58, 95%CI (0.74, 3.37), P >0.05]. Conclusions Bone mineral density and kyphosis after primary operation may be the risk factors closely correlative to the secondary fracture after percutaneous vertebroplasty. There has not been enough evidence to support the associations between the secondary fracture and gender, age, body mass index, cement volume, intradiscal cement, number of vertebrae primarily treated, thoracolumbar spine, or cement injection approach. Key words: Osteoporosis; Spinal fractures; Vertebroplasty; Subsequent fracture; Systematic review