椎体压缩性骨折后凸成形术与椎体成形术:一项荟萃分析

Q4 Medicine Coluna/ Columna Pub Date : 2022-01-01 DOI:10.1590/s1808-185120222101250913
William Zarza, N. Astur, L. Kim, Lucas Miotto, R. Mendonça, A. Gotfryd, M. F. Caffaro, R. Meves
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引用次数: 0

摘要

摘要:椎体骨折是骨质疏松症的主要并发症,在老年人中较为常见。保守治疗是骨质疏松性椎体压缩性骨折(OVCF)的首选,但对于持续疼痛的病例,需要经皮椎体骨水泥增强技术,如椎体成形术和后凸成形术。我们进行了一项系统的综述,比较两种方法的临床和影像学结果。方法:根据PRISMA和Cochrane干预措施系统评价手册进行系统评价。PICO搜索策略包括以下术语:人群- OVCFs患者;干预——Kyphoplasty;控制——Vertebroplasty;结果:疼痛、骨水泥渗漏、椎体高度、邻近节段骨折、Oswestry (ODI)和SF36。结果:定性分析纳入7篇文献,仅选取随机对照试验。450例患者采用椎体成形术(VP), 469例采用后凸成形术(KP)。VP组的渗漏率为63%,KP组为14%。然而,这些结果没有统计学意义。视觉模拟评分(VAS)、ODI和SF-36根据6个月和1年的随访结果进行评估,我们没有发现治疗之间有任何显著差异。对于椎体高度的恢复,KP组的值平均比VP组高0.71 cm, CI为95%。结论:基于这一系统综述,后凸成形术在提高椎体高度方面优于椎体成形术。至于骨水泥渗漏及其他临床结果,两种方法均无统计学上的显著优势。证据等级I;系统的回顾。
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KYPHOPLASTY VERSUS VERTEBROPLASTY IN VERTEBRAL COMPRESSION FRACTURES: A META-ANALYSIS
ABSTRACT Introduction: Vertebral fracture is the main complication of osteoporosis and is common among the elderly. Conservative treatment is the first choice for osteoporotic vertebral compression fractures (OVCF) but for persistent painful cases, percutaneous vertebral cement augmentation techniques, such as vertebroplasty and kyphoplasty, are indicated. We performed a systematic review to compare clinical and radiological outcomes of both methods. Methods: A systematic review was performed according to the PRISMA and Cochrane Handbook for Systematic Reviews of Interventions. The PICO search strategy consisted of the following terms: Population- Patients with OVCFs; Intervention- Kyphoplasty; Control- Vertebroplasty; Outcomes- Pain, Cement Leakage, Vertebral Body Height, Adjacent level fractures, Oswestry (ODI) and SF36. Results: Seven articles were included in the qualitative analysis, selecting only randomized controlled trials. Four hundred and fifty patients were treated with vertebroplasty (VP) and 469 with kyphoplasty (KP). The leakage rate of the VP group was 63% versus 14% for the KP group. However, these results were without statistical significance. The Visual Analogue Scale (VAS), ODI and SF-36 outcomes were evaluated based on the 6-month and 1-year follow-up results, and we were unable to find any significant differences between treatments. For restoration of vertebral height, the values of the KP group were, on average, 0.71 cm higher than those of the VP group, with 95% CI. Conclusion: Based on this systematic review, kyphoplasty is superior to vertebroplasty for achieving gains in vertebral body height. As regards cement leakage and other clinical outcomes, neither method showed statistically significant superiority. Level of Evidence I; Systematic review.
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
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