Bone filling bag vertebroplasty and percutaneous kyphoplasty for the treatment of thoracolumbar osteoporotic compression fractures: A meta-analysis of improving cobb angle and reducing bone cement leakage / 中国组织工程研究

ABSTRACT

BACKGROUND: It remains disputed whether bone filling bag vertebroplasty and percutaneous kyphoplasty have different treatment efficacy in the treatment of thoracolumbar osteoporotic compression fractures. OBJECTIVE: To systematically analyze the efficacy and safety of bone filling bag vertebroplasty and percutaneous kyphoplasty in the treatment of thoracolumbar osteoporotic compression fractures. METHODS: A computer-based online search of CNKI, Wanfang, VIP, CBM, EMBASE, MEDLINE, and Cochrane libraries was performed to retrieve randomized controlled trial studies regarding bone filling bag vertebroplasty and percutaneous kyphoplasty in the treatment of thoracolumbar osteoporotic compression fractures published before February 2019. Two researchers independently conducted literature screening and data extraction. According to the Cochrane Collaboration Network standard, the quality of the randomized controlled trial studies was evaluated one by one. The studies that met the inclusion criteria were analyzed using the RevMan5. 3 software. RESULTS AND CONCLUSION: Six randomized controlled trial studies were included. A total of 517 patients were included in the final analysis. Among them, 257 patients received bone filling bag vertebroplasty and 260 patients received percutaneous kyphoplasty. Meta-analysis showed that there were no significant differences in postoperative Visual Analogy Score (MD=0. 00, 95%CI -0. 09-0. 10, P=0. 94), vertebral height recovery (SMD=0. 11, 95%CI -0. 26-0. 48, P=0. 57), and Oswestry Disability Index (MD=1. 47, 95%CI -0. 45-3. 39, P=0. 13) between these two surgical procedures. But postoperative Cobb angle (MD=-1. 08, 95%CI -1. 47 to -0. 70, P < 0. 000 01) and bone cement leakage rate (RR=0. 24, 95%CI 0. 13-0. 45, P < 0. 000 01) were significantly different between these two surgical procedures. Bone filling bag vertebroplasty exhibits significant advantages in improving postoperative Cobb angle and reducing bone cement over percutaneous kyphoplasty. These two surgical procedures have similar clinical outcomes such as postoperative Visual Analogy Score, vertebral height recovery, and Oswestry Disability Index. Therefore, a large number of high-quality multicenter randomized controlled trials are needed to provide more evidence.