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

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.