Dataset Information

Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture.

ABSTRACT: Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients' quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fractures and to compile their safety and efficacy results. Materials and Methods: A systematic MEDLINE/PubMed literature search was performed, time period included articles published between January 2000 and March 2019. Original articles were selected based on their clinical relevance. Results: Four studies of interest and other cited references were analyzed. These studies reported significant pain and function improvement as well as kyphotic angle and vertebral height restoration and maintain for every implant and technique investigated. Conclusions: Although good clinical performance is reported on these devices, the small numbers of studies and patients investigated draw the need for further larger evaluation before drawing a definitive treatment decision tree to guide physicians managing patients presenting with neoplastic vertebral compression fracture.

SUBMITTER: Cornelis FH

PROVIDER: S-EPMC6722751 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture.

Cornelis Francois H FH Joly Quentin Q Nouri-Neuville Maud M Ben-Ammar Mohamed M Kastler Bruno B Kastler Adrian A Amoretti Nicolas N Hauger Olivier O

Medicina (Kaunas, Lithuania) 20190731 8

<i>Background and objectives:</i> Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients' quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fr ...[more]

PMID: 31370309

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Project description:BACKGROUND:Bone loss with aging and menopause increases the risk of fragile vertebral fracture, osteoporotic vertebral compression fracture (OVCF). The fracture causes severe pain, impedes respiratory function, lower the quality of life, and increases the risk of new fractures and deaths. Various medications have been prescribed to prevent a secondary fracture, but few study summarized their effects. Therefore, we investigated their effects on preventing subsequent OVCF via meta-analyses of randomized controlled trials. METHODS:Electronic databases, including MEDLINE, EMBASE, CENTRAL, and Web of Science were searched for published randomized controlled trials from June 2015 to June 2019. The trials that recruited participants with at least one OVCF were included. We assessed the risk of bias of every study, estimated relative risk ratio of secondary OVCF, non-vertebral fracture, gastrointestinal complaints and discontinuation due to adverse events. Finally, we evaluated the quality of evidence. RESULTS:Forty-one articles were included. Moderate to high quality evidence proved the effectiveness of zoledronate (Relative Risk, RR: 0.34; 95% CI, 0.17-0.69, p?=?0.003), alendronate (RR: 0.54; 95% CI: 0.43-0.68; p <?0.0001), risedronate (RR: 0.61; 95% CI: 0.51-0.73; p?<?0.0001), etidronate (RR, 0.50; 95% CI, 0.29-0.87, p?<?0.01), ibandronate (RR: 0.52; 95% CI: 0.38-0.71; p <?0.0001), parathyroid hormone (RR: 0.31; 95% CI: 0.23-0.41; p?<?0.0001), denosumab (RR, 0.41; 95% CI, 0.29-0.57; p?<?0.0001) and selective estrogen receptor modulators (Raloxifene, RR: 0.58; 95% CI: 0.44-0.76; p?<?0.0001; Bazedoxifene, RR: 0.66; 95% CI: 0.53-0.82; p =?0.0002) in preventing secondary fractures. Moderate quality evidence proved romosozumab had better effect than alendronate (Romosozumab vs. alendronate, RR: 0.64; 95% CI: 0.49-0.84; p =?0.001) and high quality evidence proved that teriparatide had better effect than risedronate (risedronate vs. teriparatide, RR: 1.98; 95% CI: 1.44-2.70; p <?0.0001). CONCLUSION:Zoledronate, alendronate, risedronate, etidronate, ibandronate, parathyroid hormone, denosumab and selective estrogen receptor modulators had significant secondary prevention effects on OVCF. Moderate quality evidence proved romosozumab had better effect than alendronate. High quality evidence proved PTH had better effect than risedronate, but with higher risk of adverse events.

Dataset Information

Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture.

Publications

Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture.

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