The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis
ABSTRACT Background Osteoporotic vertebral compression fractures (OVCFs) are prevalent among the elderly. Percutaneous vertebroplasty (PVA) is a commonly adopted minimally invasive treatment, yet many patients endure residual back pain (RBP) posttreatment, affecting their recovery and quality of lif...
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Wiley
2025-08-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.70095 |
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| author | Wenlong Li Bing Zhang Chencheng Mei Hui Li Ruizheng Zhu Hao Lin Jianmin Wen Yang Wu Xianzhi Ma |
| author_facet | Wenlong Li Bing Zhang Chencheng Mei Hui Li Ruizheng Zhu Hao Lin Jianmin Wen Yang Wu Xianzhi Ma |
| author_sort | Wenlong Li |
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| description | ABSTRACT Background Osteoporotic vertebral compression fractures (OVCFs) are prevalent among the elderly. Percutaneous vertebroplasty (PVA) is a commonly adopted minimally invasive treatment, yet many patients endure residual back pain (RBP) posttreatment, affecting their recovery and quality of life. Given the inconsistent prevalence of RBP across studies and the multitude of influencing factors, a systematic review and meta‐analysis is necessary to determine its prevalence and identify risk factors. Methods English (PubMed, Embase, Web of Science, Ovid, Cochrane Library) and Chinese (CNKI, WanFang Data, VIP, CBM) literature databases were systematically searched until December 31, 2023. A random‐effects meta‐analysis was used to pool prevalence rates from individual studies. The associations between the identified risk factors and RBP were also analyzed. Sensitivity and subgroup analyzes were performed to identify the source of heterogeneity and to compare the prevalence estimates across the groups. The Joanna Briggs Institute's (JBIs) quality assessment checklist was used to evaluate the quality of the included studies. The I2 tests were used to assess heterogeneity among the studies. Results A total of 5146 articles were collected. Finally, 26 articles involving 9703 participants were included. Among them, 1245 experienced RBP. The prevalence of RBP in individual studies ranged from 4.56% to 50.00%, with a median of 14.90%. The pooled prevalence was 16.3% (95% CI: 13.5%–19.1%). The prevalence was higher among females [16.1% (95% CI: 13.1%–19.1%)] than males [15.9% (95% CI: 12.5%–19.2%)]. Subgroup analysis based on evaluation time showed that the prevalence was higher at 3 months or more after surgery [total: 17.3% (95% CI: 13.2%–21.4%) vs. 15.7% (95% CI: 12.1%–19.2%), males: 16.5% (95% CI: 12.3%–20.6%) vs. 15.3% (95% CI: 11.0%–19.6%), females: 16.9% (95% CI: 12.6%–21.1%) vs. 15.5% (95% CI: 11.6%–19.5%)]. Regarding the risk factors, several factors demonstrated significant associations with RBP. Patients with low pre‐bone mineral density were more likely to experience RBP compared to those with higher density. Moreover, thoracolumbar fascia injury, unsatisfactory cement distribution, multiple vertebral fractures, and postoperative vertebral body height recovery rate were also identified as risk factors increasing the likelihood of RBP. Conclusion RBP is common after PVA, indicating the imperative of intervention strategies to alleviate the suffering and reduce negative ramifications. Moreover, various risk factors should be comprehensively considered to accurately assess patients' conditions and formulate targeted treatment and rehabilitation plans to alleviate patients' RBP symptoms. |
| format | Article |
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| spelling | doaj-art-a8a96f885c4f411b8082a5a0bdadc8d02025-08-04T03:33:16ZengWileyOrthopaedic Surgery1757-78531757-78612025-08-011782266228010.1111/os.70095The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐AnalysisWenlong Li0Bing Zhang1Chencheng Mei2Hui Li3Ruizheng Zhu4Hao Lin5Jianmin Wen6Yang Wu7Xianzhi Ma8Beijing Hepingli Hospital Beijing People's Republic of ChinaBeijing Hepingli Hospital Beijing People's Republic of ChinaBeijing Huaxin Hospital (The First Hospital of Tsinghua University) Beijing People's Republic of ChinaBeijing Hepingli Hospital Beijing People's Republic of ChinaThe Third Affiliated Hospital of Beijing University of Chinese Medicine Beijing People's Republic of ChinaBeijing Hepingli Hospital Beijing People's Republic of ChinaWangjing Hospital China Academy of Chinese Medical Sciences Beijing People's Republic of ChinaBeijing Hepingli Hospital Beijing People's Republic of ChinaBeijing Hepingli Hospital Beijing People's Republic of ChinaABSTRACT Background Osteoporotic vertebral compression fractures (OVCFs) are prevalent among the elderly. Percutaneous vertebroplasty (PVA) is a commonly adopted minimally invasive treatment, yet many patients endure residual back pain (RBP) posttreatment, affecting their recovery and quality of life. Given the inconsistent prevalence of RBP across studies and the multitude of influencing factors, a systematic review and meta‐analysis is necessary to determine its prevalence and identify risk factors. Methods English (PubMed, Embase, Web of Science, Ovid, Cochrane Library) and Chinese (CNKI, WanFang Data, VIP, CBM) literature databases were systematically searched until December 31, 2023. A random‐effects meta‐analysis was used to pool prevalence rates from individual studies. The associations between the identified risk factors and RBP were also analyzed. Sensitivity and subgroup analyzes were performed to identify the source of heterogeneity and to compare the prevalence estimates across the groups. The Joanna Briggs Institute's (JBIs) quality assessment checklist was used to evaluate the quality of the included studies. The I2 tests were used to assess heterogeneity among the studies. Results A total of 5146 articles were collected. Finally, 26 articles involving 9703 participants were included. Among them, 1245 experienced RBP. The prevalence of RBP in individual studies ranged from 4.56% to 50.00%, with a median of 14.90%. The pooled prevalence was 16.3% (95% CI: 13.5%–19.1%). The prevalence was higher among females [16.1% (95% CI: 13.1%–19.1%)] than males [15.9% (95% CI: 12.5%–19.2%)]. Subgroup analysis based on evaluation time showed that the prevalence was higher at 3 months or more after surgery [total: 17.3% (95% CI: 13.2%–21.4%) vs. 15.7% (95% CI: 12.1%–19.2%), males: 16.5% (95% CI: 12.3%–20.6%) vs. 15.3% (95% CI: 11.0%–19.6%), females: 16.9% (95% CI: 12.6%–21.1%) vs. 15.5% (95% CI: 11.6%–19.5%)]. Regarding the risk factors, several factors demonstrated significant associations with RBP. Patients with low pre‐bone mineral density were more likely to experience RBP compared to those with higher density. Moreover, thoracolumbar fascia injury, unsatisfactory cement distribution, multiple vertebral fractures, and postoperative vertebral body height recovery rate were also identified as risk factors increasing the likelihood of RBP. Conclusion RBP is common after PVA, indicating the imperative of intervention strategies to alleviate the suffering and reduce negative ramifications. Moreover, various risk factors should be comprehensively considered to accurately assess patients' conditions and formulate targeted treatment and rehabilitation plans to alleviate patients' RBP symptoms.https://doi.org/10.1111/os.70095meta‐analysisosteoporotic vertebral compression fracturespercutaneous vertebroplastyresidual back painsystematic review |
| spellingShingle | Wenlong Li Bing Zhang Chencheng Mei Hui Li Ruizheng Zhu Hao Lin Jianmin Wen Yang Wu Xianzhi Ma The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis Orthopaedic Surgery meta‐analysis osteoporotic vertebral compression fractures percutaneous vertebroplasty residual back pain systematic review |
| title | The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis |
| title_full | The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis |
| title_fullStr | The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis |
| title_short | The Prevalence and Risk Factors of Residual Back Pain After Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta‐Analysis |
| title_sort | prevalence and risk factors of residual back pain after vertebroplasty for osteoporotic vertebral compression fractures a systematic review and meta analysis |
| topic | meta‐analysis osteoporotic vertebral compression fractures percutaneous vertebroplasty residual back pain systematic review |
| url | https://doi.org/10.1111/os.70095 |
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