Kyphoplasty is associated with reduced mortality risk for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Yijian Zhang; Jun Ge; Hao Liu; Junjie Niu; Shenghao Wang; Hao Shen; Hanwen Li; Chen Qian; Zhuorun Song; Pengfei Zhu; Xuesong Zhu; Jun Zou; Huilin Yang

doi:10.1007/s00586-023-08032-5

Kyphoplasty is associated with reduced mortality risk for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Eur Spine J. 2024 Apr;33(4):1490-1497. doi: 10.1007/s00586-023-08032-5. Epub 2023 Dec 7.

Authors

Yijian Zhang^#^{1

2}, Jun Ge^#^{1

2}, Hao Liu^#^{1

2}, Junjie Niu^{1

2}, Shenghao Wang^{1

2}, Hao Shen^{1

2}, Hanwen Li^{1

2}, Chen Qian^{1

2}, Zhuorun Song^{1

2}, Pengfei Zhu^{1

2}, Xuesong Zhu^{3

4}, Jun Zou^{5

6}, Huilin Yang^{7

8}

Affiliations

¹ Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, No. 899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
² Orthopaedic Institute, Medical College, Soochow University, Suzhou, 215007, China.
³ Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, No. 899 Pinghai Road, Suzhou, 215006, Jiangsu, China. zhuxs@suda.edu.cn.
⁴ Orthopaedic Institute, Medical College, Soochow University, Suzhou, 215007, China. zhuxs@suda.edu.cn.
⁵ Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, No. 899 Pinghai Road, Suzhou, 215006, Jiangsu, China. jzou@suda.edu.cn.
⁶ Orthopaedic Institute, Medical College, Soochow University, Suzhou, 215007, China. jzou@suda.edu.cn.
⁷ Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, No. 899 Pinghai Road, Suzhou, 215006, Jiangsu, China. suzhouspine@163.com.
⁸ Orthopaedic Institute, Medical College, Soochow University, Suzhou, 215007, China. suzhouspine@163.com.

^# Contributed equally.

PMID: 38062266
DOI: 10.1007/s00586-023-08032-5

Abstract

Background: Vertebral augmentation, such as vertebroplasty (VP) or kyphoplasty (KP), has been utilized for decades to treat OVCFs; however, the precise impact of this procedure on reducing mortality risk remains a topic of controversy. This study aimed to explore the potential protective effects of vertebral augmentation on mortality in patients with osteoporotic vertebral compression fractures (OVCFs) using a large-scale meta-analysis.

Materials and methods: Cochrane Library, Embase, MEDLINE, PubMed and Web of Science databases were employed for literature exploration until May 2023. The hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized as a summary statistic via random-effect models. Statistical analysis was executed using Review Manager 5.3 software.

Results: After rigorous screening, a total of five studies with substantial sample sizes were included in the quantitative meta-analysis. The total number of participants included in the study was an 2,421,178, comprising of 42,934 cases of vertebral augmentation and 1,991,244 instances of non-operative management. The surgical intervention was found to be significantly associated with an 18% reduction in the risk of mortality (HR 0.82; 95% CI 0.78, 0.85). Subgroup analysis revealed a remarkable 71% reduction in mortality risk following surgical intervention during short-term follow-up (HR 0.29; 95% CI 0.26, 0.32). Furthermore, KP exhibited a superior and more credible decrease in the risk of mortality when compared to VP treatment.

Conclusions: Based on a comprehensive analysis of large samples, vertebral augmentation has been shown to significantly reduce the mortality risk associated with OVCFs, particularly in the early stages following fractures. Furthermore, it has been demonstrated that KP is more reliable and effective than VP in terms of mitigating mortality risk.

Keywords: Kyphoplasty; Large-scale meta-analysis; Mortality; Osteoporotic vertebral compression fractures; Vertebroplasty.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Fractures, Compression* / surgery
Humans
Kyphoplasty* / methods
Osteoporotic Fractures* / surgery
Spinal Fractures* / etiology
Treatment Outcome
Vertebroplasty* / methods

Abstract

Publication types

MeSH terms

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