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比较椎体后凸成形术和椎体成形术后的疼痛减轻情况:一项对随机和非随机对照试验的荟萃分析。

Comparing pain reduction following kyphoplasty and vertebroplasty : A meta-analysis of randomized and non-randomized controlled trials.

作者信息

Chen Chen, Shen Xiaofeng, Wang Jiangping, Zhang Zhigang, Li Yuwei, Chen Hua

机构信息

Department of Orthopaedics, Yanling Hospital of Traditional Chinese Medicine, 27 Huadudadao Road, 461000, Yanling, Henan, China.

Department of Orthopaedics, Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine, 889 Wuzhongxi Road, 215009, Suzhou, Jiangsu, China.

出版信息

Orthopade. 2017 Oct;46(10):855-863. doi: 10.1007/s00132-017-3455-x.

DOI:10.1007/s00132-017-3455-x
PMID:28821906
Abstract

PURPOSE

The aim of the study was to compare the extent of pain reduction with kyphoplasty (KP) and vertebroplasty (VP) in the treatment of osteoporotic vertebral compression fractures (OVCF) using a visual analog scale (VAS).

METHODS

A computerized database search was performed to compare pain relief from VP and KP in OVCF. The available literature was analysed to quantify the amount of pain reduction using VAS as the primary outcome.

RESULTS

A total of 10 studies encompassing 902 patients met the inclusion criteria. Subgroup meta-analyses were performed according to the study design. VAS for the KP group was not significant compared with the VP group at 1 week, 1 month, and 6 months. Pain relief in the KP group was greater than that in the VP group at 12 months and 2 years.

CONCLUSION

KP is superior to VP in patients requiring pain relief. More large-scale, double-blinded controlled trials are necessary in order to quantify the pain relief afforded by VP more precisely.

摘要

目的

本研究旨在使用视觉模拟评分法(VAS)比较椎体后凸成形术(KP)和椎体成形术(VP)在治疗骨质疏松性椎体压缩骨折(OVCF)时的疼痛减轻程度。

方法

进行计算机数据库检索,以比较OVCF中VP和KP的疼痛缓解情况。分析现有文献,以VAS作为主要结局指标来量化疼痛减轻的程度。

结果

共有10项研究(涉及902例患者)符合纳入标准。根据研究设计进行亚组荟萃分析。在1周、1个月和6个月时,KP组的VAS与VP组相比无显著差异。在12个月和2年时,KP组的疼痛缓解程度大于VP组。

结论

在需要缓解疼痛的患者中,KP优于VP。为了更精确地量化VP所带来的疼痛缓解效果,有必要进行更多大规模、双盲对照试验。

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本文引用的文献

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Randomized controlled trial of vertebroplasty versus kyphoplasty in the treatment of vertebral compression fractures.椎体成形术与后凸成形术治疗椎体压缩骨折的随机对照试验
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Pain Physician. 2015 Mar-Apr;18(2):E187-94.
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Does percutaneous kyphoplasty have better functional outcome than vertebroplasty in single level osteoporotic compression fractures? A comparative prospective study.
在单节段骨质疏松性压缩骨折中,经皮椎体后凸成形术的功能结果是否比椎体成形术更好?一项比较性前瞻性研究。
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Early or delayed operation, which is more optimal for kyphoplasty? A retrospective study on cement leakage during kyphoplasty.早期或延迟手术,对于球囊扩张椎体后凸成形术来说,哪种更优?球囊扩张椎体后凸成形术中骨水泥渗漏的回顾性研究。
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Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy.椎体成形术和后凸成形术——对骨质疏松性椎体压缩骨折的水泥增强技术与标准药物治疗的系统评价。
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Sacral kyphoplasty for the treatment of painful sacral insufficiency fractures and metastases.经皮骶骨后凸成形术治疗疼痛性骶骨不稳定性骨折和转移瘤。
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A comparison of two new technologies for percutaneous vertebral augmentation: confidence vertebroplasty vs. sky kyphoplasty.经皮椎体强化两种新技术的比较:可信椎体成形术与Sky椎体后凸成形术
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