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A Narrative Review for Mechanisms and Management of Secondary Vertebral Collapse Following Minimally Invasive Bone
Bing-Yi Yang1, Shao-Kuan Song1, Huo-Liang Zheng1
1Department of Clinic of Spine Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Objective:
This review examines the diagnostic criteria, incidence rates, risk factors, preventive strategies and therapeutic approaches for post-cement augmentation vertebral recollapse, aiming to establish standardized preventive protocols.
Methods:
A systematic literature search was conducted through databases such as PubMed, Web of Science, Embase, and Cochrane, identifying 78 studies meeting predefined criteria. Eligibility criteria focused on imaging outcomes and risk stratification.
Results:
The incidence of secondary vertebral recollapse after cement augmentation varies widely (8.5-63.3%) due to inconsistent diagnostic standards. Major risk factors include procedure-related (e.g., low cement volume), anatomical (e.g., thoracolumbar location), and patient-specific (e.g., low bone mineral density) factors. Effective prevention strategies encompass standardized diagnostic protocols combining radiological and clinical assessments, precise cement application techniques, and aggressive anti-osteoporosis therapy. Innovative materials, like mineralized collagen-modified bone cement, and tailored postoperative rehabilitation can further reduce recollapse rates. Management is tiered by severity: conservative treatment for minor collapses and surgical interventions for severe cases.
Conclusion:
Vertebral recollapse is a significant post-PVA complication impacting OVCF patient prognosis. Comprehensive risk assessment, optimized cement use, and ongoing anti-osteoporosis therapy are crucial for reducing incidence. Advancements in cement formulation, technique, and standardized therapeutic frameworks are vital for improving long-term patient outcomes.
