M J Weiss, S H Wagner, M L Bauman
A validated case study of facilitated communication
Mental retardation
percutaneous vertebroplasty kyphoplasty common interventions osteoporotic vertebral compression fractures however concern increased risk adjacentlevel fractures treatment study aimed compare risk adjacentlevel fractures vertebroplasty kyphoplasty natural history osteoporotic vertebral compression fractures network metaanalysis randomized controlled trials rcts conducted evaluate risk adjacentlevel fractures vertebroplasty kyphoplasty compared natural history osteoporotic vertebral compression fractures frequentist network metaanalysis conducted using netmeta package heterogeneity assessed using q statistics pooled risk ratio rr 95 confidence intervals ci calculated using random effects twentythree rcts total 2838 patients included analysis network metaanalysis showed comparable risks adjacentlevel fractures vertebroplasty kyphoplasty natural history osteoporotic vertebral compression fractures mean followup 212 range 3494 months pooled rr adjacentlevel fractures kyphoplasty compared natural history 135 95 ci 078234 p 023 vertebroplasty compared natural history 116 95 ci 062214 p 051 risk bias assessment showed low moderate risk bias among included rcts difference risk adjacentlevel fractures vertebroplasty kyphoplasty compared natural history osteoporotic vertebral compression fractures inclusion large patient number network metaanalysis rcts serve evidencebased clinical practice risk adjacentlevel fracture following percutaneous vertebroplasty kyphoplasty similar observed natural history osteoporotic vertebral compression fractures rcts examined risk adjacentlevel fracture intervention osteoporotic vertebral compression fractures difference vertebroplasty kyphoplasty patients compared natural disease history adjacent compression fractures strong evidence interventional treatments fractures increase risk adjacent fractures