Risk factors for new vertebral compression fracture following percutaneous vertebral augmentation: a systematic review and meta-analysis based on multivariate logistic regression analysis
Abstract
Objective: This meta-analysis investigates the prevalence and risk factors for new vertebral compression fractures (NVCF) following percutaneous vertebral augmentation (PVA) in patients with osteoporotic vertebral compression fractures (OVCF).
Methods: We searched PubMed, Cochrane Library, Embase, and Web of Science (up to June 2025) and screened case-control and cohort studies that utilized multivariate logistic regression analysis to examine the prevalence and risk factors of NVCF after PVA in OVCF patients. The meta-analysis was performed according to the PRISMA guidelines. After data extraction, STATA 15.0 was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI).
Results: This meta-analysis included 18 studies involving 7,743 patients, of whom 1,336 developed NVCF postoperatively, with a prevalence of 17.25%. The meta-analysis revealed that the risk factors for new fractures after PVA in OVCF patients were associated with Gender [OR = 1.99, 95%CI (1.50, 2.64), P < 0.001], Age [OR = 1.09, 95%CI (1.02, 1.17), P = 0.01], Bone mineral density (BMD) [OR = 0.74, 95%CI (0.63, 0.86), P < 0.001],Bone cement disc leakage [OR = 2.94, 95%CI (1.64, 5.28), P < 0.001], Lack of anti-osteoporosis treatment [OR = 2.93, 95%CI (2.14, 4.01), P < 0.001], Thoracolumbar junction (TL junction) [OR = 3.50, 95%CI (2.06, 5.93), P < 0.001], Hounsfield unit value (HU value) [OR = 0.96, 95%CI (0.95, 0.97), P < 0.001], Use of steroids [OR = 3.94, 95%CI (2.16, 7.21), P < 0.001],…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,743 participants or records.
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