A meta-analysis of unilateralversus bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer complications. OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software. RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24); MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.