Yu Hongwei, Luo Gan, Yu Bin, Sun Tianwei, Tang Qiong, Jia Yutao
School of Medicine, Nankai University, Tianjin, China.
Department of Spinal Surgery, Tian-jin Union Medical Centre, Nankai University People's Hospital, Tianjin, China.
Front Surg. 2022 Jul 5;9:955966. doi: 10.3389/fsurg.2022.955966. eCollection 2022.
This meta-analysis aimed to determine whether patients treated with robot-assisted kyphoplasty for vertebral compression fractures have superior clinical and radiographic improvement than those treated with fluoroscopy.
A comprehensive search of the PubMed, Embase, Cochrane Library, Science Direct, and CNKI (China National Knowledge Infrastructure) databases was conducted to find randomized control trials (RCTs) or observational cohort studies that compared robotic-assisted kyphoplasty (RA-kyphoplasty) with fluoroscopy-assisted kyphoplasty (FA-kyphoplasty) in treating vertebral compression fractures. Preoperative, postoperative, and final follow-up data on vertebral height (VH), vertebral kyphosis angle (VKA), visual analog scale (VAS) for back pain, and cement leakage rate were collected from eligible studies for meta-analysis. Patients were divided into RA and FA groups depending on whether the operation was robotically or fluoroscopically guided.
We included 6 cohort studies with 491 patients and 633 vertebrae. The results of the meta-analysis showed that the RA group had a higher VH than the FA group at both postoperation ( < 0.001) and final follow-up ( < 0.001); the VKA in the RA group was lower than that in the FA group at postoperation ( < 0.001) and final follow-up ( < 0.001); the back pain VAS score was lower in the RA group than in the FA group at postoperation ( = 0.01) and final follow-up ( = 0.03); and the cement leakage rate in the RA group was lower than those in the FA group ( < 0.001).
This meta-analysis demonstrated that RA-kyphoplasty outperformed FA-kyphoplasty in vertebral height restoration, kyphosis angle correction, VAS score reduction for back pain, and lower cement leakage rate in the treatment of vertebral compression fractures.
本荟萃分析旨在确定接受机器人辅助椎体后凸成形术治疗椎体压缩骨折的患者在临床和影像学改善方面是否优于接受透视引导治疗的患者。
全面检索PubMed、Embase、Cochrane图书馆、Science Direct和中国知网（CNKI）数据库，以查找比较机器人辅助椎体后凸成形术（RA-椎体后凸成形术）与透视辅助椎体后凸成形术（FA-椎体后凸成形术）治疗椎体压缩骨折的随机对照试验（RCT）或观察性队列研究。从符合条件的研究中收集术前、术后和最终随访时的椎体高度（VH）、椎体后凸角（VKA）、背痛视觉模拟量表（VAS）和骨水泥渗漏率数据，进行荟萃分析。根据手术是由机器人还是透视引导，将患者分为RA组和FA组。
我们纳入了6项队列研究，共491例患者和633个椎体。荟萃分析结果显示，术后（<0.001）和最终随访时（<0.001），RA组的VH均高于FA组；术后（<0.001）和最终随访时（<0.001），RA组的VKA低于FA组；术后（=0.01）和最终随访时（=0.03），RA组的背痛VAS评分低于FA组；RA组的骨水泥渗漏率低于FA组（<0.001）。
本荟萃分析表明，在治疗椎体压缩骨折方面，RA-椎体后凸成形术在恢复椎体高度、矫正后凸角、降低背痛VAS评分以及降低骨水泥渗漏率方面优于FA-椎体后凸成形术。
