A Meta-analysis on percutaneous vertebroplasty with high-viscosity and low-viscosity bone cement for osteoporotic vertebral compression fractures / 中国组织工程研究

ABSTRACT

BACKGROUND: Percutaneous vertebroplasty (PVP) has been proved to be effective for osteoporotic vertebral compression fractures (OVCF); however, bone cement leakage-related complications occur frequently. OBJECTIVE: To systematically evaluate the safety and complications of PVP with high-viscosity and low-viscosity bone cement in the treatment of OVCF. METHODS: We performed a systematic search by computer in PubMed, EMBASE, Cochrane Library (December, 2016) and CNKI, CBM, VIP and WanFang databases from January, 2000 to December, 2016; meanwhile, the relevant Chinese and English orthopedic journals were retrieved manually. Randomized controlled trials (RCTs) concerning the use of high-viscosity and low-viscosity bone cement in the PVP for OVCF were collected and systematically reviewed using the method recommended by the Cochrane Collaboration. The Meta-analysis was performed by using the RevMan5.2. RESULTS AND CONCLUSION: Six relevant RCTs were included, involving 554 patients (high-viscosity bone cement was used in 278 cases and low-viscosity bone cement in 276 cases). Meta-analysis results showed that postoperative pain symptoms were alleviated in all the 554 cases, and there was no significant difference in the amount of adjacent vertebral fractures between two approaches (P > 0.05). However, there was a significant difference in the visual analog scale score, Oswestry disability index value, Cobb angle, and bone cement leakage rate between high-viscosity and low-viscosity cement groups (P < 0.05). To conclude, PVP with either high-viscosity or low-viscosity bone cement can relieve pain rapidly in OVCF patients, and both approaches are safe and effective. However, high-viscosity bone cement has a lower cement leakage rate and better outcomes in visual analog scale score, Oswestry disability index, Cobb angle and cement leakage prevention as compared with low-viscosity bone cement.