{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:26:08Z","timestamp":1785421568140,"version":"3.56.0"},"reference-count":39,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Osteoporotic vertebral compression fractures (OVCFs) are common causes of pain and disability in older adults. Although percutaneous vertebroplasty (PVP) and balloon kyphoplasty (PKP) generally provide effective relief for acute fractures, some patients develop recurrent pain due to new or adjacent-level fractures after the initial procedure. Repeat VA is increasingly used, yet its efficacy and safety have not been systematically evaluated. This study aimed to synthesize current evidence and perform a meta-analysis on clinical, radiologic, and procedural outcomes of repeat VA for recurrent or adjacent OVCFs.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n Following PRISMA 2020 guidelines, PubMed, Scopus, and Web of Science were searched up until October 2025 for English-language studies reporting repeat PVP or PKP for osteoporotic fractures. Continuous outcomes (VAS, ODI, SKA, cement volume) were pooled as mean differences (MDs) and complications as pooled proportions using random-effects models. Heterogeneity was assessed with the I\u00b2 statistic, and publication bias with Egger\u2019s regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fourteen retrospective cohort studies (320 patients, 358 vertebrae) were included. Repeat VA significantly improved pain and function (VAS MD = \u22125.58 [95% CI, \u22126.32 to \u22124.83]; ODI MD = \u221241.7 [95% CI, \u221254.9 to \u221228.5]) and produced modest angular correction (SKA + 5.78\u00b0, 95% CI 4.21\u20137.36). Complications were infrequent: cement leakage 17%, adjacent fracture 5%, and re-revision 4%. No neurological or infectious events were reported.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Repeat vertebroplasty or BKP offers substantial pain reduction, functional recovery, and radiographic stabilization for recurrent or adjacent OVCFs, with complication rates comparable to primary augmentation.<\/jats:p>\n <\/jats:sec>","DOI":"10.52965\/001c.157979","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:52:58Z","timestamp":1772553178000},"source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of revision vertebral augmentation for recurrent or adjacent osteoporotic vertebral compression fractures: a systematic review and meta-analysis"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6276-2447","authenticated-orcid":false,"given":"Stylianos","family":"Kapetanakis","sequence":"first","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"},{"id":[{"id":"https:\/\/ror.org\/02j61yw88","id-type":"ROR","asserted-by":"publisher"}],"name":"2nd Department of Orthopaedics, General Hospital of Thessaloniki \u201cG. Gennimatas\u201d, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8677-4153","authenticated-orcid":true,"given":"Mikail","family":"Chatzivasiliadis","sequence":"additional","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-6880","authenticated-orcid":false,"given":"Nikolaos","family":"Gkantsinikoudis","sequence":"additional","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-5566","authenticated-orcid":false,"given":"Constantinos","family":"Chaniotakis","sequence":"additional","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8490-6843","authenticated-orcid":false,"given":"Panagiotis","family":"Konstantinou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02j61yw88","id-type":"ROR","asserted-by":"publisher"}],"name":"2nd Department of Orthopaedics, General Hospital of Thessaloniki \u201cG. Gennimatas\u201d, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Kostretzis","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02j61yw88","id-type":"ROR","asserted-by":"publisher"}],"name":"2nd Department of Orthopaedics, General Hospital of Thessaloniki \u201cG. Gennimatas\u201d, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krikor","family":"Gkoumousian","sequence":"additional","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iosafat","family":"Pinto","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02j61yw88","id-type":"ROR","asserted-by":"publisher"}],"name":"Health Unit of Veria, General Hospital of Imathia, Veria 59132, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paschalis","family":"Tsioulas","sequence":"additional","affiliation":[{"name":"Department of Spine and Deformities, European Interbalkan Medical Center, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Ditsios","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02j61yw88","id-type":"ROR","asserted-by":"publisher"}],"name":"2nd Department of Orthopaedics, General Hospital of Thessaloniki \u201cG. Gennimatas\u201d, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1007\/s00198-025-07523-z","article-title":"Risk factors for refracture or new vertebral compression fractures after percutaneous vertebroplasty: a systematic review and meta-analysis","volume":"36","author":"E. Marselou","year":"2025","journal-title":"Osteoporos Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"J. A. Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"124301","DOI":"10.1016\/j.wneu.2025.124301","article-title":"Repeated percutaneous kyphoplasty for refracture of the same cemented vertebral body","volume":"201","author":"X. Shao","year":"2025","journal-title":"World Neurosurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"166","DOI":"10.3390\/jcm14010166","article-title":"Efficiency and safety of repeated vertebroplasty for adjacent segment fractures","volume":"14","author":"B. S. Wu","year":"2024","journal-title":"J Clin Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1177\/21925682231174189","article-title":"Bone cement reperfusion revision surgery for symptomatic recurrence of K\u00fcmmell's disease after percutaneous kyphoplasty","volume":"14","author":"T. Chen","year":"2024","journal-title":"Global Spine J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1007\/s00270-018-1920-5","article-title":"Is redo vertebroplasty an effective treatment on the same vertebra?","volume":"41","author":"S. M. Park","year":"2018","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1007\/s00586-016-4784-x","article-title":"Secondary balloon kyphoplasty for new vertebral compression fracture after initial single-level balloon kyphoplasty for osteoporotic vertebral compression fracture","volume":"26","author":"D. Song","year":"2017","journal-title":"Eur Spine J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"269","DOI":"10.4103\/0019-5413.205677","article-title":"Surgical treatment of secondary fractures after percutaneous vertebroplasty: a retrospective study","volume":"51","author":"J. J. Zhu","year":"2017","journal-title":"Indian J Orthop"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1007\/s00586-017-5056-0","article-title":"Diagnosis of painful cemented vertebrae from failed vertebroplasty: modified dynamic radiographs play an important role","volume":"26","author":"Y. J. Chen","year":"2017","journal-title":"Eur Spine J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/BSD.0b013e318288a900","article-title":"Repeat percutaneous vertebroplasty for recurrent pain arising from previously treated vertebrae in patients with osteoporotic vertebral compression fractures","volume":"29","author":"L. Li","year":"2016","journal-title":"Clin Spine Surg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"46","DOI":"10.7812\/TPP\/12-037","article-title":"Evaluation and management of vertebral compression fractures","volume":"16","author":"D. Alexandru","year":"2012","journal-title":"Perm J"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"E245","DOI":"10.1097\/BSD.0b013e31825ef90f","article-title":"Clinical evaluation of repeat percutaneous vertebroplasty for symptomatic cemented vertebrae","volume":"25","author":"Y. C. Chiu","year":"2012","journal-title":"J Spinal Disord Tech"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00402-010-1236-7","article-title":"Repeated percutaneous vertebroplasty for refracture of cemented vertebrae","volume":"131","author":"L. H. Chen","year":"2011","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"278","DOI":"10.3340\/jkns.2010.47.4.278","article-title":"The retrial of percutaneous vertebroplasty for the treatment of vertebral compression fracture","volume":"47","author":"H. W. Kim","year":"2010","journal-title":"J Korean Neurosurg Soc"},{"issue":"Suppl 2","key":"ref15","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/15910199080140S215","article-title":"Repeat percutaneous vertebroplasty at cemented vertebra with fluid sign and recurrent pain","volume":"14","author":"C. C. Lin","year":"2008","journal-title":"Interv Neuroradiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1097\/BRS.0b013e318166955f","article-title":"Repeat vertebroplasty for unrelieved pain at previously treated vertebral levels with osteoporotic vertebral compression fractures","volume":"33","author":"S.C. He","year":"2008","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref17","first-page":"1657","article-title":"The therapeutic benefit of repeat percutaneous vertebroplasty at previously treated vertebral levels","volume":"23","author":"J. R., Jr. Gaughen","year":"2002","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"5126","DOI":"10.1007\/s00586-025-09111-5","article-title":"Risk factors for adjacent vertebral fracture after kyphoplasty or percutaneous vertebroplasty in osteoporotic vertebral compression fractures: a systematic review and meta-analysis","volume":"34","author":"L. He","year":"2025","journal-title":"Eur Spine J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.ijsu.2016.11.082","article-title":"Does vertebral augmentation lead to an increasing incidence of adjacent vertebral failure? A systematic review and meta-analysis","volume":"36","author":"B. Fan","year":"2016","journal-title":"Int J Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1097\/00007632-200107150-00009","article-title":"Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty","volume":"26","author":"M. A. Liebschner","year":"2001","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1007\/s00586-013-2869-3","article-title":"Cement volume is the most important modifiable predictor for pain relief in BKP: results from SWISSspine, a nationwide registry","volume":"22","author":"C. R\u00f6der","year":"2013","journal-title":"Eur Spine J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1359\/jbmr.2000.15.4.721","article-title":"Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis","volume":"15","author":"C. M. Klotzbuecher","year":"2000","journal-title":"J Bone Miner Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1097\/BSD.0b013e3182886dd2","article-title":"Repeat vertebroplasty for symptomatic cemented vertebrae","volume":"26","author":"H. Wang","year":"2013","journal-title":"J Spinal Disord Tech"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s12891-021-04355-w","article-title":"Refracture of the cemented vertebrae after percutaneous vertebroplasty: risk factors and imaging findings","volume":"22","author":"Y. C. Xiong","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"ref25","first-page":"125","article-title":"Vertebroplasty and kyphoplasty","volume":"6","author":"V. Denaro","year":"2009","journal-title":"Clin Cases Miner Bone Metab"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"5116","DOI":"10.1007\/s00586-025-09082-7","article-title":"Risk factors for new vertebral fracture after percutaneous vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures (OVCFs): an updated systematic review and meta-analysis","volume":"34","author":"Y. S. Lian","year":"2025","journal-title":"Eur Spine J"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/s13018-018-0952-5","article-title":"Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fracture: a meta-analysis and systematic review","volume":"13","author":"B. Wang","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s007760300032","article-title":"Biomechanical evaluation of kyphoplasty and vertebroplasty with calcium phosphate cement in a simulated osteoporotic compression fracture","volume":"8","author":"S. Tomita","year":"2003","journal-title":"J Orthop Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1016\/j.spinee.2007.04.004","article-title":"Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature","volume":"8","author":"J. C. Eck","year":"2008","journal-title":"Spine J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"17999","DOI":"10.1038\/s41598-024-68835-4","article-title":"Incidence and risk factors of adjacent vertebral fracture after percutaneous vertebroplasty or kyphoplasty in postmenopausal women: a retrospective study","volume":"14","author":"Y. Cheng","year":"2024","journal-title":"Sci Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1097\/JS9.0000000000000411","article-title":"Incidence and cost of vertebral fracture in urban China: a five-year population-based cohort study","volume":"109","author":"X. Q. Zheng","year":"2023","journal-title":"Int J Surg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e532","DOI":"10.1097\/MD.0000000000000532","article-title":"Risk factors and incidence of repeat osteoporotic fractures among the elderly in Taiwan: a population-based cohort study","volume":"94","author":"P. C. Hsiao","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/S0140-6736(10)60954-3","article-title":"Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial","volume":"376","author":"C. A. Klazen","year":"2010","journal-title":"Lancet"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1097\/BRS.0000000000001298","article-title":"Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures: a prospective randomized controlled clinical study","volume":"41","author":"E. Z. Yang","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s12178-007-9013-0","article-title":"Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events","volume":"1","author":"T. McCall","year":"2008","journal-title":"Curr Rev Musculoskelet Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"729257","DOI":"10.4061\/2010\/729257","article-title":"Vertebroplasty and kyphoplasty can restore normal spine mechanics following osteoporotic vertebral fracture","volume":"2010","author":"J. Luo","year":"2010","journal-title":"J Osteoporos"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.spinee.2018.06.347","article-title":"Risk factors for newly developed osteoporotic vertebral compression fractures following treatment for osteoporotic vertebral compression fractures","volume":"19","author":"B. G. Lee","year":"2019","journal-title":"Spine J"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s13018-022-03038-z","article-title":"Risk factors of vertebral re-fracture after PVP or PKP for osteoporotic vertebral compression fractures, especially in Eastern Asia: a systematic review and meta-analysis","volume":"17","author":"C. Dai","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s00586-002-0512-9","article-title":"Load shift of the intervertebral disc after a vertebroplasty: a finite-element study","volume":"12","author":"G. Baroud","year":"2003","journal-title":"Eur Spine J"}],"container-title":["Orthopedic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/157979-outcomes-of-revision-vertebral-augmentation-for-recurrent-or-adjacent-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analy","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:53:00Z","timestamp":1772553180000},"score":1,"resource":{"primary":{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/157979-outcomes-of-revision-vertebral-augmentation-for-recurrent-or-adjacent-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analy"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":39,"URL":"https:\/\/doi.org\/10.52965\/001c.157979","relation":{},"ISSN":["2035-8164"],"issn-type":[{"value":"2035-8164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]}}}