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Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis – Balloon Kyphoplasty Facts

Review

. 2016 May-Jun;36(3):165-74.


doi: 10.5144/0256-4947.2016.165.

Affiliations

Free PMC article

Review

Lin Liang et al.


Ann Saudi Med.


2016 May-Jun.

Free PMC article

Abstract


Background:

Both kyphoplasty (KP) and vertebroplasty (VP) are effective for patients with osteoporotic vertebral compression fracture (OVCF), but which approach might be more effective remains unclear, so we decided to update earlier systematic reviews.


Objective:

Review and analyze studies published as of August 2015 that compared clinical outcomes and complications of KP versus VP.


Design:

Systematic review and meta-analysis.


Search method:

Published reports up to August 2015 were found in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL).


Selection criteria:

Randomized controlled trials (RCTs) and prospective and retrospective cohort stud.ies comparing KP and VP in patients with OVCF.


Data collection and analysis:

Two authors independently assessed the studies and extracted data.


Results:

Thirty-two studies involving 3274 patients fulfilled the inclusion criteria. There were significant differences between the two groups in short- and long-term postoperative changes in measures of pain intensity and dysfunction (P < .01), in anterior and middle height (P < .01), kyphotic angle (P < .01), and time to injury, but not in posterior height (P=.178). There were no significant differences in the rate of postoperative fractures including adjacent and total fractures, but cement leakage to the intraspinal space was greater in the VP group (P=.035). KP surgery took longer and required a greater volume of injected cement.


Conclusions:

KR resulted in better pain relief, improvements in Oswestry dysfunction and radiographic outcomes with less cement leakage, but further RCTs are needed to verify this conclusion.


Limitations:

Only four RCTs with a certain of risk of bias. Most studies were observational.

Conflict of interest statement

Disclosure of conflict of interest

None.

Figures


Figure 1



Figure 1

Flow diagram for selection of articles in the meta-analysis..


Figure 2



Figure 2

Methodological quality of the randomized controlled trials (n=4) showing risk-of-bias assessment.


Figure 3



Figure 3

Summarization of risk of bias as percentages for low, unclear and high for the randomized controlled trials (n=4).


Figure 4



Figure 4

Forest plots for the meta-analysis of the visual analog scale scores.


Figure 5



Figure 5

Forest plots for the meta-analysis of the Oswestry Disability Index scores.


Figure 6



Figure 6

Forest plots for the meta-analysis of the volume of injected cement.


Figure 7



Figure 7

Forest plots for the meta-analysis of the kyphotic angle.


Figure 8



Figure 8

Forest plots for the meta-analysis of leakage.

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References

    1. Laurent M. Treatment of osteoporotic vertebral fractures. JAMA internal medicine. 2014 Apr;174(4):641–642.



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    1. Wang E, Yi H, Wang M, Huang C. Treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty: A report of 196 cases. European Journal of Orthopaedic Surgery and Traumatology. 2013;23(SUPPL 1):S71–S75.



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    1. Bonnick SL. Osteoporosis in men and women. Clinical cornerstone. 2006;8(1):28–39.



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Read more from the original source:
Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis – PubMed

Review . 2016 May-Jun;36(3):165-74. doi: 10.5144/0256-4947.2016.165. Affiliations Affiliation 1 Prof. Yangyi Zhu, Department of Orthopaedics,, Shangyu People’s Hospital, University,, No. 899 Pinghai Road, Suzhou 215006, China, Shaoxing 312000, China, F: 86057581266120, boss2014jaing@163.com, ORCID ID: orcid.org/0000-0002-2654-8360. PMID: 27236387 PMCID: PMC6074542 DOI: 10.5144/0256-4947.2016.165 Free PMC article Review Lin Liang et al. Ann Saudi Med. 2016 May-Jun. Free PMC…

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