Department of Radiology, Rutgers New Jersey Medical School, MSB Room F-506, 185 South Orange Avenue, Newark, NJ 07102.
Department of Radiology, Rutgers New Jersey Medical School, MSB Room F-506, 185 South Orange Avenue, Newark, NJ 07102.
J Vasc Interv Radiol. 2019 Nov;30(11):1845-1854. doi: 10.1016/j.jvir.2019.06.013. Epub 2019 Oct 3.
To evaluate the safety and efficacy of sacroplasty for the treatment of osteoporotic and malignant sacral fractures by performing a systematic review and meta-analysis of existing literature.
PubMed, Web of Science, and SCOPUS databases were searched from their inception until February 2018 for articles describing sacroplasty. Inclusion criteria were as follows: studies reporting > 5 patients, and pain assessment before and after the procedure recorded with visual analog scale (VAS). Demographic data, procedural details, technical success rates, VAS scores before and after the procedure, and procedural complications were recorded. A random-effects meta-analyses of the VAS pain score before the procedure, at 24-48 hours, at 6 months, and at 12 months were calculated.
Nineteen studies (18 case series and 1 cohort study) were identified consisting of 861 total patients (682 women and 167 men; mean age 73.89 ± 9.73 years). Patients underwent sacroplasty for the following indications: sacral insufficiency fractures secondary to osteoporosis (n = 664), malignancy (n = 167), and nonspecified sacral insufficiency fractures (n = 30). Technical and clinical successes were achieved in 98.9% (852/861) and 95.7% (623/651) of patients undergoing sacroplasty, respectively. The pooled major complication rate was 0.3%, with 3 patients requiring surgical decompression for cement leakage. Random-effects meta-analyses demonstrated statistically significant differences in the VAS pain level at preprocedure, 24-48 hours, 6 months, and 12 months, with cumulative pain scores of 8.32 ± 0.01, 3.55 ± 0.01, 1.48 ± 0.01, and 0.923 ± 0.01, respectively.
Sacroplasty appears safe and effective for pain relief in patients with osteoporotic or malignant sacral fractures, with statistically significant sustained improvement in VAS pain scores up to 12 months.
通过对现有文献进行系统回顾和荟萃分析，评估硫酸钙成形术治疗骨质疏松性和恶性骶骨骨折的安全性和疗效。
从建库起至 2018 年 2 月，检索 PubMed、Web of Science 和 Scopus 数据库，查找描述硫酸钙成形术的文章。纳入标准为：研究报告中患者人数>5 例，且记录了治疗前后的疼痛评估，采用视觉模拟评分（VAS）。记录人口统计学数据、手术细节、技术成功率、手术前后的 VAS 评分以及手术并发症。对手术前、24-48 小时、6 个月和 12 个月的 VAS 疼痛评分进行随机效应荟萃分析。
共确定了 19 项研究（18 项病例系列研究和 1 项队列研究），共包括 861 例患者（682 例女性和 167 例男性；平均年龄 73.89±9.73 岁）。患者因以下原因接受硫酸钙成形术治疗：骨质疏松性骶骨不稳定性骨折（n=664）、恶性肿瘤（n=167）和非特指性骶骨不稳定性骨折（n=30）。接受硫酸钙成形术的患者中，技术和临床成功率分别达到 98.9%（852/861）和 95.7%（623/651）。主要并发症发生率为 0.3%，3 例患者因水泥渗漏需要手术减压。随机效应荟萃分析显示，手术前、24-48 小时、6 个月和 12 个月时 VAS 疼痛水平存在统计学显著差异，累积疼痛评分分别为 8.32±0.01、3.55±0.01、1.48±0.01 和 0.923±0.01。
硫酸钙成形术治疗骨质疏松性或恶性骶骨骨折安全有效，VAS 疼痛评分在 12 个月内持续显著改善。
