手法复位联合微创手术治疗骨质疏松性椎体压缩骨折的疗效：一项Meta分析

[Effectiveness of manipulative reduction combined with minimally invasive surgery in the treatment of osteoporotic vertebral compression fracture: a meta-analysis].

作者信息

Hu Yue-ming, Pang Qing-jiang

出版信息

Zhongguo Gu Shang. 2015 Nov;28(11):1042-7.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of manipulative reduction combined with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF) using meta-analysis method, in order to provide a reference for clinical treatment.

METHODS

A systematic computer-based search (from January 1987 to April 2014) from CNKI, Wanfang database, Web of Science and PubMed were performed for the collection of controlled clinical researches on manipulative reduction combined with PVP or PKP in treating OVCF. The quality of selected researches was evaluated. Meta-analysis was adopted to evaluate visual analog scale, Cobb angle, anterior height ratio of the injured vertebra.

RESULTS

A total of 7 researches of 410 patients were included in the present analysis, there were 5 RCTs and 2 non-RCTs and all come from China. Manipulative reduction combined with PVP could got better improvement in Cobb angle (WMD=-7.35; 95%CI: -12.15, -2.54) and anterior height ratio of the injured vertebra (P<0.01) than simple PVP, but no significant difference was found in improvement of visual analog scale (WMD=-0.01; 95%CI: -0.45, 0.42). There were no significant differences in the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra between manipulative reduction combined with PKP and simple PKP (P>0.05).

CONCLUSION

Compared with simple PVP, manipulative reduction combined with PVP may result in more clinical efficacy on the improvement of Cobb angle and anterior ratio of the injured vertebra. And compared with simple PKP, manipulative reduction combined with PKP has no obvious advantages on the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra. However, the number and quality of the literatures, may resulted in the effect of mistrust, so more large sample and high-quality RCTs are needed in future.

摘要

目的

采用Meta分析方法评价手法复位联合经皮椎体成形术（PVP）或经皮后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折（OVCF）的临床疗效，为临床治疗提供参考。

方法

通过计算机系统检索（检索时间为1987年1月至2014年4月）中国知网、万方数据库、Web of Science及PubMed，收集手法复位联合PVP或PKP治疗OVCF的对照临床研究。对纳入研究的质量进行评价，采用Meta分析方法评价视觉模拟评分、Cobb角、伤椎前缘高度比值。

结果

本分析共纳入7项研究410例患者，其中5项随机对照试验（RCT），2项非随机对照试验，均来自中国。手法复位联合PVP在改善Cobb角（加权均数差[WMD]=-7.35；95%可信区间[CI]：-12.15，-2.54）和伤椎前缘高度比值（P<0.01）方面优于单纯PVP，但在改善视觉模拟评分方面差异无统计学意义（WMD=-0.01；95%CI：-0.45，0.42）。手法复位联合PKP与单纯PKP在改善视觉模拟评分、Cobb角、伤椎前缘高度比值方面差异无统计学意义（P>0.05）。