Risk factors for non-operative vertebral fractures after PVP in Chinese: a meta-analysis

English Keywords:Compressive fracture  Vertebroplasty  Risk factors  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To systematically evaluate the risk factors of non-operative vertebral fractures after vertebroplasty(PVP) in Chinese population, and to provide reference for the clinical prevention and control of non-operative vertebral fractures. Methods: Electronic databases including Pubmed, Embase, Cochrane Library, CNKI, VIP and Wanfang were searched to identity studies that assessed the risk factors of non-operative vertebral fractures after PVP in Chinese from January 1987 to February 2018. The inclusion criteria were documents published and valid data available. The exclusion criteria were pathological fracture and NOS literature quality score <6 points. Two researchers strictly evaluated the quality of literature and extracted literature. The research indicators of the data statistically analyzed and extracted by Revman 5.3 software, included: gender, number of preoperative vertebral fractures, without anti-osteoporosis treatment, bone cement leakage intervertebral disc, BMI index, kyphosis correction degree, age, parathyroid hormone, bone mineral density(BMD). Results: Fifteen articles met the criteria, including 8 Chinese articles and 7 English articles. A total of 3177 patients was included. There were 588 cases of non-operative vertebral fracture after PVP. Meta-analysis showed that the risk factors associated with non-operative vertebral fracture after PVP in Chinese population included: multiple preoperative vertebral fractures[OR=1.61, 95%CI=(1.08, 2.39), P＜0.05], bone cement leaking into intervertebral disc[OR=2.44, 95%CI=(1.32, 4.51), P＜0.05], without postoperative anti-osteoporosis treatment[OR=3.47, 95%CI=(2.36, 5.09), P＜0.05], female[OR=1.36, 95%CI=(1.06, 1.75), P＜0.05], advanced age[WMD=0.86, 95%CI=(0.10, 1.62), P＜0.05], low bone density[WMD=-0.66, 95%CI=(-1.09, -0.22), P＜0.05], high parathyroid hormone[WMD=4.67, 95%CI=(4.22, 5.13), P＜0.05], but the BMI index[WMD=-0.13, 95%CI=(-1.55, 1.28), P＞0.05] and correction degree of kyphosis [WMD=1.92, 95%CI=(-1.16, 4.99), P＞0.05] were not related to the incidence of non-operative vertebral fracture after PVP. Conclusions: Multiple preoperative vertebral fractures, bone cement leakage into intervertebral disc, postoperative unosteoporosis treatment, advanced age, correction degree of excessive kyphosis, high parathyroid hormone, female, low bone density are the risk factors for non-operative vertebral fractures after PVP in Chinese.