弯角与双侧椎弓根入路椎体成形术的荟萃分析

Percutaneous curved vertebroplasty versus bilateral-pedicle-approach percutaneous vertebroplasty for osteoporotic vertebral compression fracture:a meta-analysis

[目的]系统评价弯角椎体成形术(percutaneous curved vertebroplasty,PCVP)与双侧椎弓根入路椎体成形术(bilateral-pedicle-approach percutaneous vertebroplasty,bPVP)治疗骨质疏松性椎体压缩骨折的有效性和安全性。[方法]计算机检索2020年1月之前EMBASE、PubMed、Cochrane Library、中国知网、万方数据、中国生物医学文献数据库,收集有关PCVP与bPVP治疗骨质疏松性椎体压缩骨折的随机对照试验,采用Stata/SE 12.0软件进行Meta分析。[结果]共纳入6篇随机对照试验,包含428例患者,其中217例患者采用PCVP,211例采用bPVP。Meta分析结果显示:PCVP在术后VAS评分(MD=-0.12,95%CI-0.21~-0.04,P=0.005)、骨水泥渗漏率(RR=0.36,95%CI 0.18~0.75,P=0.006)、X线曝光次数(MD=-9.35,95%CI-10.68~-8.02,P<0.05)、骨水泥注入量(MD=-1.58,95%CI-1.89~-1.28,P<0.05)和手术时间(MD=-14.93,95%CI-18.12~-11.73,P<0.05)方面均显著优于b PVP。[结论]PCVP在止痛效果和安全性方面优于bPVP。

[Objective]To systematically evaluate the efficacy and safety of percutaneous curved vertebroplasty(PCVP)versus bilateral-pedicle-approach percutaneous vertebroplasty(bPVP)for osteoporotic vertebral compression fracture(OVCF).[Methods]The EMBASE,PubMed,Cochrane Library,CNKI,WanFang and CBM databases were retrieved to find the randomized-controlled trials on PCVP versus bPVP for treatment of osteoporotic vertebral compression.After literature screening,data extraction and quality evaluation were conducted by two evaluators,and then a meta-analysis was done by using Stata/SE 12.0 software.[Results]A total of 6 randomized-controlled trials were included,involving 428 patients,217 treated with PCVP and 211 with bPVP.As results of the meta-analysis,the PCVP proved significantly superior to the bPVP regarding postoperative VAS score(MD=-0.12,95%CI-0.21~-0.04,P=0.005),leakage rate of bone cement(RR=0.36,95%CI 0.18~0.75,P=0.006),X-ray exposure times(MD=-9.35,95%CI-10.68~-8.02,P<0.05),volume of bone cement injected(MD=-1.58,95%CI-1.89~-1.28,P<0.05),and operation time(MD=-14.93,95%CI-18.12~-11.73,P<0.05).[Conclusions]The PCVP is considerably superior to the b PVP in term of pain relief and safety of the operation.