Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China.
Eur Spine J. 2022 May;31(5):1122-1130. doi: 10.1007/s00586-022-07150-w. Epub 2022 Mar 6.
To compare high- versus low-viscosity bone cement on the clinical outcomes and complications in patients with Osteoporotic vertebral compression fractures (OVCFs) who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).
PubMed, Embase, and the Cochrane Library were searched for papers published from inception up to February 2021 for potentially eligible studies comparing high- versus low-viscosity cement for PVP/PKP. The outcomes were the leakage rate, visual analog scale (VAS), and Oswestry Disability Index (ODI).
Eight studies (558 patients; 279 in each group) were included. The meta-analysis showed that the leakage rate was lower with high-viscosity cement than with low-viscosity cement (OR = 0.23, 95%CI 0.14-0.39, P < 0.001; I = 43.5%, P = 0.088); similar results were observed specifically for the disk space, paravertebral space, and peripheral vein, but there were no differences regarding the epidural space and intraspinal space. The VAS was decreased more significantly with high-viscosity cement than with low-viscosity cement (WMD = - 0.21, 95%CI - 0.38, - 0.04, P = 0.015; I = 0.0%, P = 0.565). Regarding the ODI, there was no difference between high- and low-viscosity cement (WMD = - 0.88, 95%CI - 3.06, 1.29, P = 0.426; I = 78.3%, P < 0.001).
There were lower cement leakage rates in PVP/PKP with high-viscosity bone cement than low-viscosity bone cement. The two groups have similar results in ODI, but the VAS scores favor high-viscosity bone cement. Therefore, the administration of high-viscosity bone cement in PVP/ PKP could be a potential option for improving the complications of leakage in OVCFs, while the clinical efficacy of relieving pain is not certain.
比较经皮椎体成形术（PVP）或经皮后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折（OVCFs）患者中高黏度与低黏度骨水泥的临床结果和并发症。
检索 PubMed、Embase 和 Cochrane 图书馆，以获取截至 2021 年 2 月可能符合条件的比较高黏度与低黏度骨水泥用于 PVP/PKP 的研究。结果为渗漏率、视觉模拟评分（VAS）和 Oswestry 残疾指数（ODI）。
纳入 8 项研究（558 例患者；每组 279 例）。荟萃分析显示，高黏度骨水泥的渗漏率低于低黏度骨水泥（OR=0.23，95%CI 0.14-0.39，P<0.001；I=43.5%，P=0.088）；在椎间盘间隙、椎旁间隙和外周静脉中观察到类似的结果，但在硬膜外间隙和椎管内间隙中无差异。高黏度骨水泥的 VAS 降低更显著（WMD=-0.21，95%CI-0.38，-0.04，P=0.015；I=0.0%，P=0.565）。关于 ODI，高黏度与低黏度骨水泥之间无差异（WMD=-0.88，95%CI-3.06，1.29，P=0.426；I=78.3%，P<0.001）。
在 PVP/PKP 中使用高黏度骨水泥的渗漏率低于低黏度骨水泥。两组在 ODI 方面的结果相似，但 VAS 评分倾向于高黏度骨水泥。因此，在 PVP/ PKP 中使用高黏度骨水泥可能是改善 OVCFs 渗漏并发症的一种潜在选择，而缓解疼痛的临床疗效尚不确定。
