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Research ArticleSpine Imaging and Spine Image-Guided Interventions

The Association between the Duration of Preoperative Pain and Pain Improvement in Vertebral Augmentation: A Meta-Analysis

A. Ehteshami Rad, M.T. Luetmer, M.H. Murad and D.F. Kallmes
American Journal of Neuroradiology February 2012, 33 (2) 376-381; DOI: https://doi.org/10.3174/ajnr.A2618
A. Ehteshami Rad
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M.T. Luetmer
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M.H. Murad
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D.F. Kallmes
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    Fig 1.

    Inclusion of the final 17 articles.

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    Fig 2.

    The forest plot shows subgroup analysis.

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    Fig 3.

    The linear correlation between preoperative pain duration and pain improvement is shown.

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    Fig 4.

    Publication bias among studies is shown.

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    Fig 5.

    The cumulative meta-analysis shows the influence of increasing preoperative pain duration on the outcome of the study.

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    Fig 6.

    The cumulative meta-analysis shows the influence of increasing sample size on the outcome of the study.

Tables

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    Table 1:

    Characteristics of included studies

    AuthorsStudy DesignSA TypePatients (levels)Preoperative PainPostoperative VASaLevel of Evidence
    Age of FractureVAS
    Alvarez et al1Prospective, double cohortVP101 (152)5 Months8.94.02
    Conservative27 (28)5.8 Months7.37.3
    Chen et al19RetrospectiveVP70 (87)8 Months80 (0–100)38 (0–100)4
    Diamond et al20Prospective, non-randomizedVP88 (133)1–6 Weeks20 (0–25)8 (0–25)2
    Conservative38 (NA)1–6 Weeks20 (0–25)19 (0–25)
    Garfin et al21Prospective single-arm interventional cohortKP155 (214)128.5 Days15 (0–20)5 (0–20)4
    Kallmes et al28Randomized double-blinded controlled trialPlacebo63 (93)20 Weeks7.23.91
    VP68 (95)16 Weeks6.94.2
    Kobayashi et al29ProspectiveVP175 (250)19 Days7.22.14
    Lee et al30RetrospectiveKP105 (132)4.5 Weeks8.72.34
    Liu et al31Randomized clinical trialKP50 (50)15.8 Days8.02.62
    VP50 (50)17 Days7.92.3
    Prather et al32ProspectiveVP50 (103)14 Months7.83.14
    Rapan et al33NAVP55 (85)44 Days8.362.234
    Rhyne et al25RetrospectiveKP52 (82)31 Weeks9.162.94
    Rolloinghoff et al34ProspectiveKP45 (53)3 Weeks8.63.42
    VP45 (51)3 Weeks8.84.8
    Rousing et al35Randomized clinical trialConservative24 (32)6.7 Days8.8NA2
    VP25 (31)8.4 Days7.52.0
    Schofer et al36ProspectiveKP30 (30)9.5 Days8.23.22
    VP30 (30)10.5 Days8.33.0
    Vogl et al26RetrospectiveVP61 (NA)19 Days8.82.64
    Voormolen et al9ProspectiveVP112 (168)4 Months8.83.34
    Wardlaw et al31Randomized clinical trialConservative151 (195)6.4 Weeks7.05.92
    KP149 (214)5.6 Weeks6.93.6
    • ↵a Visual Analog Scale.

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    Table 2:

    Demographics of categories with various preoperative pain durationsa

    ≤6 Weeks20,26,29–31,34–376–24 Weeks1,9,21,28,33>24 Weeks19,25,32
    No. of included studies1253
    No. of patients (mean) (SD, range)71 (49, 25–175)98 (39, 55–155)57 (11, 50–70)
    No. of levels (mean) (SD, range)93 (78, 30–250)143 (53, 85–214)91 (11, 82–103)
    Preoperative pain duration by week (mean) (SD, range)2.7 (1.3, 1.2–5.6)15.9 (5.7, 6.3–21.5)42 (16, 31–60)
    • ↵a The studies11,13,15 that did not present a single number for preoperative pain or age of fracture were excluded from this calculation.

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    Table 3:

    Details of meta-analysis under the random-effects model

    Point EstimateStandard ErrorVarianceLower LimitUpper LimitZ valueP value
    ≤6 Weeks5.180.2630.0694.665.7019.683<.001
    6–24 Weeks4.900.4060.1654.115.7012.081<.001
    >24 Weeks5.040.5470.2993.976.116.110<.001
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American Journal of Neuroradiology: 33 (2)
American Journal of Neuroradiology
Vol. 33, Issue 2
1 Feb 2012
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A. Ehteshami Rad, M.T. Luetmer, M.H. Murad, D.F. Kallmes
The Association between the Duration of Preoperative Pain and Pain Improvement in Vertebral Augmentation: A Meta-Analysis
American Journal of Neuroradiology Feb 2012, 33 (2) 376-381; DOI: 10.3174/ajnr.A2618

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The Association between the Duration of Preoperative Pain and Pain Improvement in Vertebral Augmentation: A Meta-Analysis
A. Ehteshami Rad, M.T. Luetmer, M.H. Murad, D.F. Kallmes
American Journal of Neuroradiology Feb 2012, 33 (2) 376-381; DOI: 10.3174/ajnr.A2618
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