Outcomes of vertebroplasty compared with kyphoplasty: a systematic review and meta-analysis

被引：51

作者：

Gu, Chris N. ^{[1
]}

Brinjikji, Waleed ^{[1
]}

Evans, Avery J. ^{[2
]}

Murad, Mohammad H. ^{[3
]}

Kallmes, David F. ^{[1
,4
]}

机构：

[1] Mayo Clin, Dept Radiol, 200 1st St SW, Rochester, MN 55905 USA

[2] Univ Virginia, Dept Radiol & Med Imaging, Charlottesville, VA USA

[3] Mayo Clin, Ctr Sci Healthcare Delivery, Rochester, MN 55905 USA

[4] Mayo Clin, Dept Neurosurg, Rochester, MN 55905 USA

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2016年 / 8卷 / 06期

关键词：

D O I：

10.1136/neurintsurg-2015-011714

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Background and purpose Many studies demonstrate that both kyphoplasty and vertebroplasty are superior to conservative therapy in the treatment of osteoporotic vertebral body compression fractures. We performed a systematic review and meta-analysis of studies comparing the outcomes of vertebroplasty and kyphoplasty, which included prospective non-randomized, retrospective comparative, and randomized studies. Materials and methods We searched MEDLINE, EMBASE, and the Web of Science databases for studies of kyphoplasty versus vertebroplasty from 1 January 1990 to 30 November 2014 and compared the following outcomes: procedure characteristics, pain and disability improvement, complications and anatomic outcomes. A subgroup analysis was performed comparing pain outcomes based on the risk of bias. Results 29 studies enrolling 2838 patients (1384 kyphoplasty and 1454 vertebroplasty) were included. 16 prospective non-randomized studies, 10 retrospective comparative studies, and 3 randomized controlled studies were included. No significant differences were found in mean pain scores between the two groups postoperatively (2.9 +/- 1.5 kyphoplasty vs 2.9 +/- 1.7 vertebroplasty, p=0.39) and at 12 months (2.7 +/- 1.8 kyphoplasty vs 3.2 +/- 1.8 vertebroplasty, p=0.64). No significant differences were found in disability postoperatively (34.7 +/- 7.1 kyphoplasty group vs 36.3 +/- 7.8 vertebroplasty group, p=0.74) or at 12 months (28.3 +/- 16 kyphoplasty group vs 29.6 +/- 13.9 vertebroplasty group, p=0.70). Kyphoplasty was associated with lower odds of new fractures (p=0.06), less extraosseous cement leakage (p<0.01), and greater reduction in kyphotic angle (p<0.01). Conclusions No significant difference was found between vertebroplasty and kyphoplasty in short- and long-term pain and disability outcomes. Further studies are needed to better determine if any particular subgroups of patients would benefit more from vertebroplasty or kyphoplasty in the treatment of vertebral body compression fractures.

引用

页码：636 / 642

页数：7

共 21 条

[1]

Kim D.H., Vaccaro A.R., Osteoporotic compression fractures of the spine

[2]

Current options and considerations for treatment, Spine J, 6, pp. 479-487, (2006)

[3]

Boonen S., Van Meirhaeghe J., Bastian L., Et al., Balloon kyphoplasty for the treatment of acute vertebral compression fractures: 2-year results from a randomized trial, J Bone Miner Res, 26, pp. 1627-1637, (2011)

[4]

Boonen S., Wahl D.A., Nauroy L., Et al., Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures, Osteoporos Int, 22, pp. 2915-2934, (2011)

[5]

Han S., Wan S., Ning L., Et al., Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials, Orthop, 35, pp. 1349-1358, (2011)

[6]

Klazen C.A., Lohle P.N., De Vries J., Et al., Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): An open-label randomised trial, Lancet, 376, pp. 1085-1092, (2010)

[7]

Wardlaw D., Cummings S.R., Van Meirhaeghe J., Et al., Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): A randomised controlled trial, Lancet, 373, pp. 1016-1024, (2009)

[8]

Goz V., Koehler S.M., Egorova N.N., Et al., Kyphoplasty and vertebroplasty: Trends in use in ambulatory and inpatient settings, Spine J, 11, pp. 737-744, (2011)

[9]

Liu J.T., Liao W.J., Tan W.C., Et al., Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: A prospective, comparative, and randomized clinical study, Osteoporos Int, 21, pp. 359-364, (2010)

[10]

Dohm M., Black C.M., Dacre A., Et al., A Randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis, AJNR Am J Neuroradiol, 35, pp. 2227-2236, (2014)

← 1 2 3 →