RESUMO
Osteoporotic vertebral fractures (OVFs) frequently result in pain and decreased quality of life (QoL). The management of these fractures remains a topic of debate. Following PRISMA guidelines, we analyzed RCTs comparing PV with non-operative treatment (non-OT). The outcomes of interest included pain, QoL, cement leakage, and new OVFs after one year. Compared to non-OT regarding pain relief, PV yielded significant improvement at 1-2 weeks, 1 month, 6 months (SMD = -0.67 (6/14; 95% CI: -1.29 to -0.06; I2 = 92%, random effects) and 1 year (MD = - 1.07 (4/14; 95% CI: -1.97 to -0.18; I2 = 97%, random effects). For QoL, notable improvements were observed at 1 week (SMD = -2.10 (5/14; 95% CI: -3.77 to -0.42; I2 = 98%, random effects) and 3 months (MD = -1.58 (4/14; 95% CI: -3.07 to -0.09; I2 = 96%, random effects), with 1 month, 6 months and 1 year being inconclusive. A cement leakage rate of 42 % (10/14; 95% CI: 25% to 59%; I2 = 99%, random effects) was found. Further, PV did not significantly heighten the risk of new fractures within a year (OR = 1.26 (6/14; 95% CI: 0.63 to 2.53; I2 = 74%, random effects). PV emerges as a promising intervention for specific time intervals regarding pain relief, especially in the extended-term analysis, and QoL, especially in the short-term analysis, compared to non-OT. However, clinicians must consider cement leakage risks. Heterogeneity among studies underscores careful patient selection.
