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经皮椎体成形术与保守治疗对骨质疏松性椎体压缩骨折治疗效果的比较:一项Meta分析

A Comparison of Percutaneous Vertebroplasty Versus Conservative Treatment in Terms of Treatment Effect for Osteoporotic Vertebral Compression Fractures: A Meta-Analysis.

作者信息

Zhang Lin, Zhai Pei

机构信息

Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

Surg Innov. 2020 Feb;27(1):19-25. doi: 10.1177/1553350619869535. Epub 2019 Aug 18.

Abstract

. Osteoporotic vertebral compression fractures (OVCFs) are common in older patients, which can cause back pain and even increase morbidity. However, the optimal therapy for patients with OVCFs remains unknown. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, has been a therapy option that is known to be effective in the pain management. . The meta-analysis aims to summarize current best evidence on the efficacy of PVP and conservative treatment (CT) for pain management and functional results among OVCFs patients. . We searched the publications on comparison of the efficacy of PVP versus CT for OVCFs patients up to November 2018. After rigorous reviewing on the quality, the data were extracted from eligible trials. All trials analyzed the summary hazard ratios of the endpoints of interest. . Moderate-strong evidence indicated that PVP had benefits on pain relief at 1 week and 1 month, but not at 3 months. With regard to the quality of life, no significant differences were found in the Roland-Morris Disability Questionnaire (RMDQ). However, there is significant difference in terms of EuroQol and Quality of Life Questionnaire of the European Foundation for Osteoporosis but not the RMDQ. Moreover, there were no any benefit in terms of vertebral fracture between groups. . The meta-analysis showed that patients treated with vertebroplasty were associated with better pain relief and improved quality of life, without increasing the incidence of vertebral fracture compared with the CT group.

摘要

骨质疏松性椎体压缩骨折(OVCFs)在老年患者中很常见,可导致背痛甚至增加发病率。然而,OVCFs患者的最佳治疗方法仍不明确。经皮椎体成形术(PVP)是一种微创手术,是已知在疼痛管理方面有效的治疗选择。 这项荟萃分析旨在总结关于PVP和保守治疗(CT)在OVCFs患者疼痛管理和功能结果方面疗效的当前最佳证据。 我们检索了截至2018年11月关于PVP与CT对OVCFs患者疗效比较的出版物。在对质量进行严格审查后,从符合条件的试验中提取数据。所有试验分析了感兴趣终点的汇总风险比。 中-强证据表明,PVP在1周和1个月时对缓解疼痛有好处,但在3个月时没有。关于生活质量,在罗兰-莫里斯残疾问卷(RMDQ)中未发现显著差异。然而,在欧洲五维度健康量表和欧洲骨质疏松症基金会生活质量问卷方面存在显著差异,但在RMDQ方面没有。此外,两组在椎体骨折方面没有任何益处。 荟萃分析表明,与CT组相比,接受椎体成形术治疗的患者疼痛缓解更好,生活质量得到改善,且未增加椎体骨折的发生率。

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