title: Risk factors for new vertebral compression fractures after vertebroplasty: a meta-analysis.
abstract: BACKGROUND
  The risk factors for new vertebral compression fractures (VCFs) after vertebroplasty are unclear. The aim of this meta-analysis was to identify potential risk factors.
  
  
  METHODS
  A systematic electronic literature search was performed using the following databases: PubMed, Embase and Cochrane Library; the databases were searched from the earliest available records in 1966 to May 2015. Pooled odds ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. The Newcastle-Ottawa scale was used to evaluate the methodological quality of the studies, and Stata 11.0 was used to analyse the data.
  
  
  RESULTS
  The primary factors that were associated with new fractures after vertebroplasty were low bone mineral density (SMD -0.375; 95% CI -0.579 to -0.171), steroid usage (OR 2.632; 95% CI 1.399 to 4.950) and the presence of multiple treated vertebrae (OR 2.027; 95% CI 1.442 to 2.851). The data did not support that age, sex, body mass index, non-steroidal anti-inflammatory drug usage, vacuum cleft, thoracolumbar junction, cement volume, kyphosis correction, or intradiscal cement leakage could lead to infection after vertebroplasty.
  
  
  CONCLUSIONS
  The present analysis demonstrated that low bone mineral density, the presence of multiple treated vertebrae and a history of steroid usage were associated with the new VCFs after vertebroplasty. Patients with these factors should be informed of the potential increased risk.
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Junming
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Lingde
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Fantao
authors.initials: F
authors.lastname: Meng
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Yingze
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
mesh_terms: D050815:Fractures, Compression / Q000453:epidemiology / Q000601:surgery*; D014943:Global Health; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000601:surgery*; D054854:Vertebroplasty / Q000009:adverse effects*
keywords: meta-analysis; osteoporotic; risk factor; vertebral compression fracture; vertebroplasty