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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Risk factors for adjacent vertebral fracture after kyphoplasty or percutaneous vertebroplasty in osteoporotic vertebral systematic review and meta-analysis compression fractures.

  • 2025-07-14
  • European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 34(11)
    • Lei He
    • Wei Li
    • Xingpeng Zhai
    • Zhiwei Li

Study Design

Type
Meta-Analysis
Sample size
n = 7,604
Population
patients with osteoporotic vertebral compression fractures who underwent percutaneous vertebroplasty or percutaneous kyphoplasty
Methods
systematic review and meta-analysis of case-control studies; searched multiple databases up to July 17,2024; two independent reviewers; meta-analysis using Stata 17.0

Objective

To systematically evaluate the risk factors of adjacent vertebral re-fracture after percutaneous vertebroplasty and percutaneous kyphoplasty for osteoporotic vertebral compression fractures.

Methods

PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM and other databases were searched by computer to collect case-control studies on adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. The retrieval time was from the establishment of the database to July 17,2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using Stata 17.0 software.

Results

A total of 26 articles were included, including 7604 patients. The results of Meta-analysis showed that postoperative bone cement leakage, excessive recovery rate of vertebral height, too little or too much bone cement injection, low bone mineral density, high recovery rate of anterior vertebral height, no anti-osteoporosis treatment after operation, too many injured vertebrae, previous history of fracture, older age and female patients were risk factors for AVCF. High level of bone cement distribution index, physical exercise after operation and low BMI index are protective factors for AVCF.

Conclusion

There are many risk factors for adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. Medical staff should make comprehensive assessment, prevention and intervention.

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