Long-term complications of percutaneous kyphoplasty for osteoporotic vertebral compression fractures: a Meta-analysis

English Keywords:Osteoporosis  Vertebral compression fractures  Percutaneous kyphoplasty  Randomized controlled trial  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To evaluate the long-term complications of percutaneous kyphoplasty(PKP) for osteoporotic vertebral compression fractures(OVCF), and to provide evidence for clinical procedure. Methods: Databases including CNKI, CBM, PubMed, The Cochrane Library(Issue 2, 2017), Wiley Online Library, ELSEVIER Science Direct(SDOS) were used to collect the randomized controlled trials(RCTs) which compared PKP with conservative treatment in the treatment of OVCF from inception to February 2017. The diagnosis of thoracolumbar vertebral compression fracture was confirmed by X-ray, CT and MRI. The presence of thoracolumbar osteoporotic T which was less than or equal to -2.5, was confirmed by bone mineral density measurement. All the patients were 50 years or older, and disease duration was less than 6 months; postoperative outcomes included at least one of the following indicators: new vertebral fractures, adjacent fractures, serious adverse events, visual analogue score. Cochrane system evaluation manual 5.0.1 was referred to evaluate the quality of the included literatures. Results: Five RCT studies included four English literatures and one Chinese literature. Methodological quality assessment of 4 articles were more than or equal to 4 points, one article scored 3 points. PKP group consisted of 417 cases, conservative treatment group of 458 cases. The results of meta-analysis showed that there was statistical difference in VAS between the two groups after 3 to 6 months′ treatment(mean difference=-0.36; 95%CI -0.07 to -0.65; P=0.02). However, there was no statistical difference in new vertebral fractures, adjacent fractures or serious adverse events. Conclusions: Application of PKP in OVCF can reduce the patients′ long-term(3-6 months) VAS pain score and does not increase the risks of new vertebral fractures, adjacent fractures and serious adverse events.