High viscosityversus common viscosity bone cement systems in the treatment of osteoporotic vertebral compressive fractures：a Meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND:Vertebroplasty system has been proved to be effective for osteoporotic vertebral compressive fracture (OVCF); however, bone cement leakage-related complications occur frequently. Thereafter, high-viscosity bone cement system with high safety and efficacy is developed, but there is stil a lack of large-scale and high quality research. OBJECTIVE:To systematicaly review the efficacy and safety of high viscosityversus common bone cement systems for OVCF. METHODS: PubMed, Embase, Cochrane Library, CNKI, CqVip and WanFang databases were searched to colect the literatures about randomized controled trials (RCTs) or clinical controled trials (CCTs) of high viscosityversus common bone cement systems for OVCF published before January 2016. The quality assessment of included literatures and data extraction were performed by two researchers independently according to the Cochrane system. Data analysis was conducted using RevMan 5. 2 software. RESULTS AND CONCLUSION:Four RCTs and six CCTs were enroled. The results of Meta-analysis indicate that there were no significant differences in the volume of bone cement [MD=0.17, 95%CI(-0.04, 0.38)], visual analogue scale scores [RCTMD=-0.30, 95%CI(-0.72, 0.11); CCTMD=-0.05, 95%CI(-0.43, 0.32)] and incidence of second fractures [OR=1.77, 95%CI(0.24, 12.86)] between two bone cements. However, patients undergoing high viscosity bone cement system have significantly lower Oswestry disability index scores [MD=-2.99, 95%CI(-5.85,-0.13)], greater recovery of Cobb angle [MD=-3.19, 95%CI(-5.27,-1.10)] and lower incidence of cement leakage [OR=0.35, 95%CI(0.24, 0.51)]. High viscosity bone cement system in the treatment of OVCF shows good results at recovery of spinal structure and function and reducing leakage. Due to the limited quantity of included literature sand high heterogeneity, more large scale and high quality RCTs are stil needed for further verification.