Impact of sarcopenia on outcomes of percutaneous vertebroplasty and kyphoplasty: a comprehensive metaanalysis.

Abstract

This meta-analysis evaluated the impact of sarcopenia on the efficacy and safety of percutaneous vertebroplasty and kyphoplasty in patients with osteoporotic vertebral compression fractures. Following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, a systematic literature search was conducted to identify studies comparing outcomes between patients with and without sarcopenia undergoing vertebroplasty or kyphoplasty. Twelve studies involving 1,786 patients were included. The primary outcomes were pain (measured using the Visual Analog Scale), refractures, disability (using the Oswestry Disability Index), length of hospital stay, and mortality rates. Heterogeneity was assessed using the I2 statistic. Mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, applying a random-effects model when heterogeneity was present. Patients with sarcopenia experienced significantly higher pain (MD, 0.82; 95% CI, 0.47-1.17; p<0.00001), greater disability (MD, 5.70; 95% CI, 4.54-6.87; p<0.00001), and increased refracture risk (OR, 2.58; 95% CI, 1.13-5.89; p=0.02) compared with those without sarcopenia. Length of hospital stay was also longer, and mortality rates were significantly higher in the sarcopenia group. Sarcopenia is an important risk factor for adverse outcomes after vertebroplasty and kyphoplasty. A systematic assessment of sarcopenia and the development of tailored perioperative strategies may help mitigate these risks and improve patient outcomes (PROSPERO registration no., CRD42024628263).