Tang Binbin, Hu Shengjia, Yuan Yifeng, Zhou Hang, Shi Xiaolin
Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, China.
Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, China.
J Int Med Res. 2025 Jul;53(7):3000605251353732. doi: 10.1177/03000605251353732. Epub 2025 Jul 4.
ObjectiveThis study aimed to evaluate the efficacy and safety of vertebroplasty versus posterior pedicle screw fixation combined with vertebroplasty in treating stage III Kummell's disease without neurological deficits.MethodA systematic literature search was conducted across six databases. A meta-analysis of prospective and retrospective studies meeting the inclusion criteria was conducted using Review Manager 5.4.1.ResultsEight studies (one prospective, one randomized control trial, and six retrospective) involving 409 patients were included. Vertebroplasty demonstrated advantages over posterior pedicle screw + vertebroplasty in operative time (weighted mean difference: -83.22 min; 95% confidence interval: -97.70 to -68.73; p<0.05), blood loss (weighted mean difference: -158.65 mL; 95% confidence interval: -219.99 to -97.31; p<0.05), and hospital stay (weighted mean difference: -5.64 days; 95% confidence interval: -7.36 to -3.92; p<0.05). No significant differences were observed in Cobb's angle (weighted mean difference: 1.28°; 95% confidence interval: -0.21 to 2.78; p>0.05), relative anterior vertebral height (weighted mean difference: 2.98%; 95% confidence interval: -4.15 to 10.11; p>0.05), cement leakage (13.2% vs. 8.5%; odds ratios: 1.67; 95% confidence interval: 0.86-3.24; p>0.05), or wound infection (0% vs. 4.88%; odds ratios: 0.28; 95% confidence interval: 0.07-1.15; p>0.05).ConclusionBoth vertebroplasty and posterior pedicle screw + vertebroplasty are effective for treating stage III Kummell's disease without neurological deficits. Vertebroplasty offers superior perioperative outcomes with reduced surgical trauma and hospital stay.PROSPERO registration number: CRD420251031065.
目的
本研究旨在评估椎体成形术与后路椎弓根螺钉固定联合椎体成形术治疗无神经功能缺损的Ⅲ期Kummell病的疗效和安全性。
方法
在六个数据库中进行了系统的文献检索。使用Review Manager 5.4.1对符合纳入标准的前瞻性和回顾性研究进行荟萃分析。
结果
纳入八项研究（一项前瞻性研究、一项随机对照试验和六项回顾性研究），共409例患者。椎体成形术在手术时间（加权平均差：-83.22分钟；95%置信区间：-97.70至-68.73；p<0.05）、失血量（加权平均差：-158.65毫升；95%置信区间：-219.99至-97.31；p<0.05）和住院时间（加权平均差：-5.64天；95%置信区间：-7.36至-3.92；p<0.05）方面比后路椎弓根螺钉+椎体成形术更具优势。在Cobb角（加权平均差：1.28°；95%置信区间：-0.21至2.78；p>0.05）、相对椎体前缘高度（加权平均差：2.98%；95%置信区间：-4.15至10.11；p>0.05）、骨水泥渗漏（13.2%对8.5%；比值比：1.67；95%置信区间：0.86 - 至3.24；p>0.05）或伤口感染（0%对4.88%；比值比：0.28；95%置信区间：0.07 - 至1.15；p>0.05）方面未观察到显著差异。
结论
椎体成形术和后路椎弓根螺钉+椎体成形术治疗无神经功能缺损的Ⅲ期Kummell病均有效。椎体成形术具有更好的围手术期效果，手术创伤和住院时间减少。
CRD420251031065。
