椎体后凸成形术与椎体成形术对骨质疏松性椎体压缩骨折患者疼痛及伤椎影像学参数指标的影响：一项Meta分析

Effect of vertebral kyphoplasty versus vertebroplasty on pain and indicators of imaging parameters of the injured vertebrae in patients with osteoporotic vertebral compression fractures: a meta-analysis.

作者信息

You Zhenjun, Wu Keqin, Jiang Yi, Chen Jing

机构信息

Department of Orthopaedic Surgery, Affiliated Hospital of Jiaxing University, Jiaxing City, Zhejiang Province, China.

Department of Laboratory Medicine, Affiliated Hospital of Jiaxing University, No.1882, Zhonghuan South Road, Jiaxing City, Zhejiang Province, China.

出版信息

J Orthop Surg Res. 2025 Feb 25;20(1):199. doi: 10.1186/s13018-025-05621-6.

DOI:10.1186/s13018-025-05621-6

PMID:40001072

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11863920/

Abstract

OBJECTIVE

To systematically evaluate the effects of vertebroplasty (VP) and kyphoplasty (KP) on pain and spinal imaging parameters in patients with osteoporotic vertebral compression fractures (OVCF).

METHODS

A comprehensive search of eight databases was conducted from inception to November 2024 to identify randomised controlled trials (RCTs) published in Chinese and English. Eligible studies included clinical RCTs comparing KP and VP in patients with OVCF, assessing vertebral pain and imaging parameters. Risk of bias and methodological quality were assessed using the Cochrane Appraisal Tool. Combined effects were calculated using a random effects model. Heterogeneity was assessed using the I test.

RESULTS

A total of 16 randomised controlled trials involving 1738 patients were included. The analysis revealed no statistically significant difference between KP and VP in pain reduction (SMD = 0.08, 95% CI = -0.04 to 0.20, P = 0. 19) or spinal function (SMD = 0.04, 95% CI = -0.11 to -0.19, P = 0. 62). However, KP demonstrated significantly better outcomes than VP in vertebral compression rate (SMD = 1.39, 95% CI = 0.81 to 1.96, P < 0. 00001), Cobb angle (SMD = 1.83, 95% CI = 0.99 to 2.68, P < 0. 0001) and the incidence of cement leakage (OR = 1.92, 95% CI = 1.41 to 2.62, P < 0. 0001).

CONCLUSION

Our results suggest that KP is more effective than VP in improving postoperative vertebral compression rate and Cobb angle, and reducing the incidence of cement leakage.

摘要

目的

系统评价椎体成形术（VP）和后凸成形术（KP）对骨质疏松性椎体压缩骨折（OVCF）患者疼痛及脊柱影像学参数的影响。

方法

从数据库建库至2024年11月，全面检索了8个数据库，以识别发表的中英文随机对照试验（RCT）。符合条件的研究包括比较OVCF患者中KP和VP的临床RCT，评估椎体疼痛和影像学参数。使用Cochrane评估工具评估偏倚风险和方法学质量。采用随机效应模型计算合并效应。使用I检验评估异质性。

结果

共纳入16项随机对照试验，涉及1738例患者。分析显示，KP和VP在减轻疼痛（标准化均数差[SMD]=0.08，95%可信区间[CI]= -0.04至0.20，P = 0.19）或脊柱功能（SMD = 0.04，95%CI = -0.11至0.19，P = 0.62）方面无统计学显著差异。然而，在椎体压缩率（SMD = 1.39，95%CI = 0.81至1.96，P < 0.00001）、Cobb角（SMD = 1.83，95%CI = 0.99至2.68，P < 0.0001）和骨水泥渗漏发生率（比值比[OR]=1.92，95%CI = 1.41至2.62，P < 0.0001）方面，KP的结果显著优于VP。