• World Neurosurg · Jul 2023

    Review Meta Analysis

    Risk factors for hidden blood loss associated with vertebroplasty or kyphoplasty for osteoporotic vertebral compression fracture：A systematic review and meta-analysis.

    • Kexin Qin, Heshun Tian, Kaihui Zhang, Luming Li, and Baoshan Xu.
    • Department of Minimally Invasive Spine Surgery, Tianjin Hospital, Tianjin, China; Graduate School, Tianjin Medical University, Tianjin, China.
    • World Neurosurg. 2023 Jul 1; 175: 475647-56.

    ObjectiveHidden blood loss (HBL), as a perioperative complication of percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP), affects the quality of life of older adults with poor health status, but it is often ignored by clinical surgeons. The purpose of this study was to discuss the risk factors for perioperative HBL through meta-analysis.MethodsWe systematically searched PubMed, Embase, Cochrane Library, Web of Science, Scopus, Google Scholar, Chinese National Knowledge Infrastructure, and Wan Fang from establishment of the database to September 2022. All eligible studies regarding risk factors for HBL after PVP or PKP were included. Heterogeneity was assessed using the χ2 test and I2 statistic percentages. If I2 >50% or P < 0.1, the random-effect model was used; otherwise, the fixed-effect model was used. Data were analyzed with Revman 5.4 and Stata 16.0.ResultsEleven studies involving 1506 patients were included and the average HBL of PKP and PVP was 278.57 mL and 276.12mL. The results showed that bone cement leakage (P < 0.0001), thoracic vertebra (P < 0.00001), bilateral surgical approach (P = 0.0008), ≥2 fracture segments (P < 0.00001), vertebral body height loss rate (≥1/3) (P < 0.00001), and vertebral body height restoration rate (≥1/3) (P < 0.00001) were risk factors for increased HBL. Diabetes (P = 0.12) and hypertension (P = 0.52) were not significantly associated with HBL.ConclusionsThe findings of this meta-analysis suggested that fracture level, surgical approach, number of fracture levels, cement leakage, vertebral height loss and restoration rate were significant risk factors for HBL, which had certain guiding significance for clinical surgeons to take reasonable measures to deal with this complication.Copyright © 2023 Elsevier Inc. All rights reserved.

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