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Meta-Analysis
. 2011 Sep;35(9):1349-58.
doi: 10.1007/s00264-011-1283-x. Epub 2011 Jun 3.

Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials

Shiliang Han  1 , Shuanglin Wan, Lei Ning, Yongjun Tong, Jianfeng Zhang, Shunwu Fan
Affiliations
Meta-Analysis

Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials

Shiliang Han et al. Int Orthop. 2011 Sep.

Abstract

Purpose: There is still debate over whether vertebroplasty (VP) or kyphoplasty (KP) is superior for the treatment of osteoporosis vertebral compression fractures (VCFs). We performed a systematic review and meta-analysis of randomised and non-randomised controlled trials comparing VP with KP to reach a relatively conclusive answer.

Methods: We searched computerised databases comparing efficacy and safety of VP and KP in osteoporotic fractures. These trials reported pain relief (Visual Analogue Scale), disability (Oswestry disability score) and complications (i.e., cement leakage, incident fractures) as the primary outcome.

Results: Eight studies involving 848 patients were identified. The outcome showed that VP is more effective in the short-term (no more than seven days) pain relief. Kyphoplasty had a superior capability for intermediate-term (around three months) functional improvement. As for long-term pain relief and functional improvement, there is no significant difference between these two interventions. Consistently, both interventions have similar risk for subsequent fracture and cement leakage.

Conclusion: Thus considering the higher cost of the KP procedure, we recommend VP over KP for the treatment of osteoporotic VCFs.

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Figures

Fig. 1
Fig. 1
Flow chart summarised the selection process of trials
Fig. 2
Fig. 2
Risk of bias assessment of included studies
Fig. 3
Fig. 3
Forest plot: mean difference in VAS and 95% CI for short-term follow-ups
Fig. 4
Fig. 4
Forest plot: mean difference in ODI and 95% CI for intermediate-term follow-ups
Fig. 5
Fig. 5
Forest plot: relative risks in cement leakage and 95% CI
Fig. 6
Fig. 6
Forest plot: relative risks in subsequent fracture and 95% CI
Fig. 7
Fig. 7
Funnel plot for the outcome of subsequent vertebral compression fractures
See this image and copyright information in PMC

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