Altern Ther Health Med. 2022 Jul;28(5):49-53.
Osteoporotic vertebral compression fractures (OVCFs) are acknowledged to be common fractures, especially in the elderly population. Minimally invasive percutaneous methods of treatment for these fractures such as kyphoplasty (KP) and vertebroplasty (VP) have been valid and effective tools for decreasing clinical problems, which are associated with more beneficial effects compared with traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence for the systematic assessment of clinical and radiographic outcomes of KP compared with VP.
We searched articles published based on the electronic databases, including PubMed, EMBASE, and Cochrane Library. Publications of studies comparing KP with VP in the treatment of OVCFs were collected. After rigorous and thorough review of study quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the end points of interest.
Our inclusion criteria involved a total of 6 studies. In total, data from 644 patients, 330 who received VP and 284 who received KP, were included in the review. There was no significant difference in either group in terms of visual analog scale (VAS) scores (MD = 0.17; 95% CI, -0.39 to 0.73; P = .56), risk of cement leakage (odds ratio [OR] = 1.31; 95% CI, 0.62 to 2.74; P = .47) or Oswestry Disability Index (ODI) scores (MD = 0.51; 95% CI, -1.87 to 2.88; P = .68). Nevertheless, the injected cement volume (MD = -0.52; 95% CI, -0.88 to -0.15; P = .005) in the VP group was linked to a markedly lower statistically significant trend compared with the KP group.
This meta-analysis evaluated acceptable efficacy levels across the involved trials. VP injected cement volume had several advantages in this meta-analysis. Yet, no significant differences were observed in terms of VAS scores, ODI scores, or cement leakage when KP was compared to VP therapy. Given the combined results of our study, the optimal treatment for patients with OVCFs should be determined by further high-quality multicenter randomized controlled trials with longer follow-up and larger sample sizes.
骨质疏松性椎体压缩性骨折（OVCFs）是公认的常见骨折，尤其是在老年人群中。经皮微创治疗方法，如椎体后凸成形术（KP）和椎体成形术（VP），已成为减少与传统方法（如开放手术或保守治疗）相关的临床问题的有效工具，具有更有益的效果。因此，我们进行了这项荟萃分析，以收集关于 KP 与 VP 治疗 OVCFs 的临床和影像学结果的系统评估的最新证据。
我们检索了基于电子数据库的文章，包括 PubMed、EMBASE 和 Cochrane 图书馆。收集了比较 KP 与 VP 治疗 OVCFs 的研究出版物。在严格彻底审查研究质量后，我们根据合格试验提取数据，分析了感兴趣终点的汇总风险比（HRs）。
我们的纳入标准共涉及 6 项研究。共有 644 名患者，其中 330 名接受 VP 治疗，284 名接受 KP 治疗，纳入了本次综述。两组患者在视觉模拟评分（VAS）评分（MD = 0.17；95%CI，-0.39 至 0.73；P =.56）、水泥渗漏风险（比值比 [OR] = 1.31；95%CI，0.62 至 2.74；P =.47）或 Oswestry 残疾指数（ODI）评分（MD = 0.51；95%CI，-1.87 至 2.88；P =.68）方面均无显著差异。然而，与 KP 组相比，VP 组注射的水泥体积（MD = -0.52；95%CI，-0.88 至 -0.15；P =.005）明显较低，呈统计学显著趋势。
本荟萃分析评估了纳入试验的可接受疗效水平。在本荟萃分析中，VP 注射的水泥体积具有一些优势。然而，与 VP 治疗相比，KP 组在 VAS 评分、ODI 评分或水泥渗漏方面无显著差异。考虑到我们研究的综合结果，对于 OVCFs 患者的最佳治疗方法应由进一步的高质量多中心随机对照试验来确定，这些试验需要更长的随访时间和更大的样本量。
