Evidence map›Paper›PMID 40269511›Full record

ArticleOrthopaedic surgery2025

Improved Kyphotic Restoration Reduces the Incidence of Adjacent Vertebral Fracture in Patients With Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Kyphoplasty: A Clinical Study and Corresponding Numerical Simulations.

Jian Yang, Zan Chen, Lipeng Zheng, Fei Lei, Wenhao Yang, Yueming Song, Jingchi Li

Abstract read
In one paragraph

Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Transverse process-pedicle versus conventional transpedicular approach in percutaneous kyphoplasty for osteoporotic vertebral compression fractures: a systematic review and pilot meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jian YangDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, China.ORCID https://orcid.org/0000-0001-7319-8888
Zan ChenDepartment of Orthopedic, The Affliated Hospital of Southwest Medical University, Luzhou, China.ORCID https://orcid.org/0000-0003-2858-6237
Lipeng ZhengDepartment of Orthopedic, The Affliated Hospital of Southwest Medical University, Luzhou, China.
Fei LeiDepartment of Orthopedic, The Affliated Hospital of Southwest Medical University, Luzhou, China.
Wenhao YangDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.
Yueming SongDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital/West China School of Medicine for Sichuan University, Chengdu, China.ORCID https://orcid.org/0000-0002-2377-0740
Jingchi LiDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.ORCID https://orcid.org/0009-0001-3411-4810

Funding

the 1-3-5 project for disciplines of excellence, West China Hospital, Sichuan University ZYGD21001the Science and Technology Department of Sichuan Province 2022YFS0628-B1
6 · The paper itself

Abstract

objectiveAdjacent vertebral fracture (AVF) is a commonly observed complication in patients with osteoporotic vertebral compressive fractures (OVCF) following percutaneous kyphoplasty (PKP). The primary etiology of this complication is the deterioration of the biomechanical environment. Local kyphotic deformity plays a critical role in influencing the direction of load transmission, which subsequently affects the local biomechanical conditions. However, whether the improved restoration of sagittal alignment can biomechanically lower the incidence of AVF remains to be determined. This paper aimed to investigate the influence of kyphotic deformity on AVF and its corresponding biomechanical mechanism.

methodsClinical data of PKP-treated patients with OVCF were retrospectively reviewed in this study. The current patient cohort was divided into two groups based on the clinical outcomes observed during the follow-up period (with and without AVF). Kyphotic angles were measured from the preoperative and postoperative lateral radiographs of these patients, and the variations between these values were calculated to denote the kyphotic restoration value. Significant differences in these parameters were analyzed between patients with and without AVF. Moreover, the biomechanical influences of segmental kyphotic angles on adjacent segment stress values were determined using a well-validated numerical model to explain the biomechanical mechanisms underlying clinically observed phenomena.

resultsClinical data of 121 PKP-treated patients with OVCF were enrolled in this study. The preoperative kyphotic angles between the two groups were comparable (12.83 ± 5.98, 12.93 ± 6.66, p = 0.942). By contrast, compared with patients with AVF, patients without AVF suffered significantly lower postoperative kyphotic angle values (10.11 ± 4.84, 7.85 ± 5.24, p = 0.044). Correspondingly, the kyphotic restoration was significantly better in patients without AVF (2.72 ± 2.26, 5.08 ± 4.2, p = 0.055). In addition, stress concentration is more evident in the model with severe fracture segmental kyphosis.

conclusionsThe clinical review and biomechanical simulations revealed that a greater degree of kyphotic correction during PKP procedures, along with a decreased postoperative kyphotic deformity, may help lower the incidence of AVF by easing stress concentration in the neighboring vertebral bodies. This topic deserves further validation through future prospective studies.

Indexed as

Fractures, CompressionKyphoplastyKyphosisOsteoporotic FracturesPostoperative ComplicationsSpinal FracturesAgedAged, 80 and overBiomechanical PhenomenaFemaleHumansIncidenceMaleMiddle AgedRetrospective Studiesadjacent vertebral fracturekyphotic angleosteoporotic vertebral compressive fracturepercutaneous vertebralplastystress concentration

Identifiers

PMID40269511
PMCPMC12146118

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.