title: Incidence of subsequent vertebral body fractures after vertebroplasty.
abstract: The causal relationship between vertebroplasty and new-onset vertebral fractures remains unproved. We undertook a systematic review and meta-analysis of randomized controlled trials to assess whether vertebroplasty increases the incidence of new vertebral fractures and adjacent vertebral fractures. A systematic literature search of PubMed, EMBASE and Cochrane Library databases up to April 2013 was conducted. Eligible studies were randomized controlled trials of osteoporotic vertebral fracture patients receiving vertebroplasty. Risk ratios (RR) and 95% confidence intervals (CI) were calculated and heterogeneity was assessed with both the chi-squared test and the I(2) test. Four studies with a total of 454 patients met the inclusion criteria. All four studies described the incidence of new vertebral fractures and three studies described adjacent vertebral fractures. The pooled results revealed that vertebroplasty was not associated with a significant increase in the incidence of new vertebral fractures (RR 1.12, 95% CI 0.75-1.67; p=0.59) or adjacent vertebral fractures (RR 2.31, 95% CI 0.36-15.06; p=0.38). Based on available evidence, it cannot be concluded that vertebroplasty can significantly increase the postoperative rate of new vertebral fractures and adjacent vertebral fractures. However, due to some limitations, the results of this meta-analysis should be cautiously accepted, but further studies are needed.
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, People's Republic of China.
authors: Ying-Ze
authors: YZ
authors: Zhang
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, People's Republic of China.
authors: Ling-De
authors: LD
authors: Kong
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, People's Republic of China.
authors: Jun-Ming
authors: JM
authors: Cao
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, People's Republic of China.
authors: Wen-Yuan
authors: WY
authors: Ding
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, People's Republic of China. Electronic address: shenyongspine@126.com.
authors: Yong
authors: Y
authors: Shen
mesh_terms: D006801:Humans; D015994:Incidence; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016103:Spinal Fractures / Q000453:epidemiology* / Q000601:surgery*; D054854:Vertebroplasty
keywords: Conservative treatment; Meta-analysis; New vertebral fractures; Osteoporosis; Vertebroplasty