Τίτλος:
Adverse Prognostic Factors and Optimal Intervention Time for
Kyphoplasty/Vertebroplasty in Osteoporotic Fractures
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Introduction. While evidence supports the efficacy of vertebral
augmentation (kyphoplasty and vertebroplasty) for the treatment of
osteoporotic fractures, randomized trials disputed the value of
vertebroplasty. The aim of this analysis is to determine the subset of
patients that may not benefit from surgical intervention and find the
optimal intervention time. Methods. 27 prospective multiple-arm studies
with cohorts of more than 20 patients were included in this
meta-analysis. We hereby report the results from the metaregression and
subset analysis of those trials reporting on treatment of osteoporotic
fractures with kyphoplasty and/or vertebroplasty. Results. Early
intervention (first 7 weeks after fracture) yielded more pain relief.
However, spontaneous recovery was encountered in hyperacute fractures
(less than 2 weeks old). Patients suffering from thoracic fractures or
severely deformed vertebrae tended to report inferior results. We also
attempted to formulate a treatment algorithm. Conclusion. Intervention
in the hyperacute period should not be pursued, while augmentation after
7 weeks yields less consistent results. In cases of thoracic fractures
and significant vertebral collapse, surgeons or interventional
radiologists may resort earlier to operation and be less conservative,
although those parameters need to be addressed in future randomized
trials.
Συγγραφείς:
Papanastassiou, Ioannis D.
Filis, Andreas
Aghayev, Kamran and
Kokkalis, Zinon T.
Gerochristou, Maria A.
Vrionis, Frank D.
Περιοδικό:
BioMed Research International
