| Title： | Guidelines for the Prevention and Treatment of Vertebral Refracture after Vertebral Augmentation for Osteoporotic Thoracolumbar Compression Fracture (2024 Edition) |
| Edition： | Original |
| Classification： | Standard guideline |
| Field： | Diagnosis and Treatment |
| Countries and regions： | China |
| Guidelines users： | Spine surgeon |
| Evidence classification method： | Use GRADE(Grading of Recommendations Assessment，Development，and Evaluation) assess the hierarchy of evidence.Level I is a prospective randomized controlled study, level II is a prospective non-randomized controlled study, level III is a retrospective case-control study, and level IV is a case series report. The recommendation level corresponds to the literature rating standard, and the recommendation intensity is divided into 3 levels, decreasing from 1 to 3. Level 1 recommendation: (1) High quality Level I evidence studies with statistically significant differences, or high quality Level I evidence studies with narrow confidence intervals although the differences are not statistically significant; (2) A systematic review of Level I evidence studies (provided that these included studies are homogeneous). Level 2 recommendation: (1) Level I evidence studies of lower quality (e.g., follow-up rate <80%, non-blind control, randomization is not appropriate); (2) Level II evidence research; (3) A systematic review of the results of different quality Level I evidence studies; (4) Systematic review of Level II evidence studies. Level 3 recommendation: Level III or Level IV evidence study. |
| Development unit： | Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association |
| Registration time: | 2024-11-04 |
| Registration number： | PREPARE-2024CN030 |
| Purpose of the guideline: | As the aging population progresses, spinal compression fractures due to osteoporosis are becoming more common. The segment of the spine most prone to osteoporotic fractures is the thoracolumbar segment. For osteoporotic thoracolumbar compression fractures, the most commonly used clinical treatment is vertebral body strengthening (such as percutaneous vertebroplasty and percutaneous kyphoplasty), which has the advantages of good pain relief and rapid restoration of the patient's mobility, which is in line with the rehabilitation concept of ERAS. However, some patients have vertebral re-fracture after surgery, which seriously affects the patients' quality of life and brings a lot of trouble to spine surgeons. How to prevent and manage vertebral body re-fracture has been the focus of discussion among spine surgeons, and there is a lack of expert consensus and clinical guidelines in this area. Based on the above, led by the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association, through a systematic literature review, discussed by the representatives of domestic spine experts, and based on evidence-based medicine, we intend to work together to formulate this guideline. with a view to providing reference for the standardization of vertebral re-fracture prevention and treatment after vertebral body strengthening for osteoporotic thoracolumbar compression fractures, to improve the clinical prognosis of patients, and to save medical costs. |
