Mortality outcomes of vertebral augmentation (vertebroplasty and/or balloon kyphoplasty) for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Category: Scientific Paper

Mortality outcomes of vertebral augmentation (vertebroplasty and/or balloon kyphoplasty) for osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Authors: Hinde K, Maingard J, Hirsch JA, Phan K, Asadi H, Chandra RV.
Publication date: 27/11/24

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Authors

Hinde K, Maingard J, Hirsch JA, Phan K, Asadi H, Chandra RV.

Institute

Department of Radiology / Interventional Radiology – Australian Hospitals.

Journal

Radiology. 2020 Apr;295(1):96-103.

Take Home message

Vertebral augmentation in case of osteoporotic fracture reduces significantly mortality by 22% compared to conservative treatment.

Study details		Score	Range
Subject	Clinical	-	-
Type	Systematic review and meta-analysisy	3	1 - 5
Journal	Radiology	3	1 - 3

Summary

Literature was analyzed and a meta-analysis was performed on mortality outcomes of patients with OVCF treated with vertebral augmentation (VA) compared with patients treated with non-surgical management (NSM)

Sample characteristics

> 2 million patients
16 studies (USA, Austria, Germany, UK, Australia, Taiwan, China)

Database

PubMed, EMBASE, Cochrane

Method

PRISMA

Quality Assessment

Newcastle-Ottawa Scale

Mortality benefit

More evident in large sample studies
Consistent across both 2- and 5-year follow-up periods

96.8% (30/31) vs 92.5% (37/40)

Heterogeneity

Substantial across study samples

Sensitivity analysis

No single study was a key contributor to heterogeneity

Bias (Egger test)

Results for publication bias were not significant (P=0.23)

Comments

NSM involves bed rest, opioids analgesia, muscle relaxants, back braces. All these carry adverse risks.
VA may provide mortality benefit by avoiding prolonged NSM through pain relief and reduced deformity.

Key points

Hazard ratios for mortality benefit for VA vs NSM across 2- and 5-year periods was 0.70 (P<0.001) and 0.79 (P=0.05), respectively
Pooled hazard ratio for mortality comparing VA with NSM was 0.78 (P =0 .003) at up to 10 years.
BKP provided a mortality benefit over PVP in the treatment of OVCF with hazard ratio of 0.77 versus 0.87 (P< 0.001)

Read on PubMed Find out more about Vertebral augmentation

Study score and Journal

Study value	Description
*	Retrospective study
* *	Retrospective comparative Retrospective Register study
* * *	Prospective study Systematic review Meta-analysis
* * * *	Randomized controlled trial (RCT)
* * * * *	Systematic review of RCT

Journal value	Description
*	Low impact factor (<1.500)
* *	Medium impact factor (>1.500 – <2.500)
* * *	High impact factor (> 2.500)