椎体后凸成形术与椎体成形术治疗骨质疏松性椎体压缩骨折的Meta分析

Kyphoplasty versus vertebroplasty for osteoporotic vertebral compression fracture：a Meta analysis

中文关键词:  椎体后凸成形术  椎体成形术  骨质疏松症  椎体压缩骨折  Meta分析

英文关键词:Kyphoplasty  Vertebroplasty  Osteoporosis  Vertebral compression fracture  Meta analysis

中文摘要:

  【摘要】 目的：用Meta分析的方法评价椎体后凸成形术（percutaneous kyphoplasty，PKP）与椎体成形术（percutaneous vertebroplasty，PVP）治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）的疗效及安全性。方法：计算机检索1997年1月～2011年1月的Ovid medline数据库、Web of science数据库、EMbase数据库及Cochrane central register of controlled trial（2011年第1期），手工检索相关杂志，搜集关于PKP与PVP治疗骨质疏松性椎体压缩骨折疗效比较的对照研究。按纳入和排除标准筛选文献，评价文献质量后采用RevMan 5.0.25进行数据分析。结果：最终纳入9个非随机前瞻性对照试验，1个随机对照试验，共749例患者。两组（PKP组及PVP组）病例术后疼痛症状均得到缓解，随访1年内患者，PKP组疼痛缓解效果略高于PVP组（P＜0.05）；随访大于1年者，PKP组效果明显高于PVP组（P<0.05）；两组病例术后疼痛功能障碍均得到缓解，但两组间效果无明显差异（P＞0.05）。大多数研究表明PVP组在矫正畸形和恢复椎体高度方面更有优势（P<0.05），但亦有部分研究认为2组间无差异性（P＞0.05）；两组病例在生活质量改善上效果相似（P＞0.05）；两组病例术后并发症发生率上PKP组小于PVP组（P＜0.05）。结论：PKP在缓解疼痛、增加椎体高度及纠正畸形方面较PVP更有优势，且更为安全，但不能完全否定PVP的作用。

英文摘要:

  【Abstract】 Objective：To evaluate the efficacy and safety of kyphoplasty versus vertebroplasty for osteoporotic vertebral compression fracture（OVCF）．Method：A systematic computer-based search（from Jan 1997 to Jan 2011）of Ovid medline，Web of science，EMbase，Cochrane central register of controlled trial（Issue 1 of 4，2011） and manual search of related journals were performed for collecting controlled trials on kyphoplasty and vertebroplasty for OVSF．The included trials were screened based on the inclusion and exclusion criteria.The quality of included trials was evaluated.RevMan 5.0.25 software was used for data analysis．Result：9 non-randomized prospective and controlled trials and 1 randomized controlled trial involving a total of 749 patients were included．PKP and PVP groups reached remarkable pain relief，and the former had more pain relief than the latter in 1 year（P＜0.05），while this difference was more significant over 1 year（P<0.05）.Two groups had severe improvement of disability，but no inter-group difference was noted（P＞0.05）.Majority of literatures showed PVP was superior than PKP in restoring vertebral height and deformity correction（P<0.05），however some papers considered no difference existed between 2 groups（P＞0.05）；2 groups had similar effect on life quality improvement（P＞0.05），however as for complications，PKP group had fewer complications noted than PVP group（P＜0.05）.Conclusion：Kyphoplasty is superior in pain relief，correction of deformity and height restoration than vertebroplasty，nevertheless PVP can not be denied．