经皮椎体成形术与经皮球囊扩张椎体后凸成形术治疗中国人Kümmell's病疗效的Meta分析

目的通过Meta分析比较经皮椎体成形术（percutaneous vertebroplasty, PVP）与经皮球囊扩张椎体后凸成形术（percutaneous kyphoplasty, PKP）治疗中国人Kümmell's病的疗效差异。 方法在Embase、Pubmed、Central、Cinahl、PQDT、中国知网、维普、万方、Cochrane Library、CBM等数据库中检索2008年10月至2018年10月已发表的关于PVP和PKP治疗中国人Kümmell's病的临床对照研究。根据纳入和排除标准筛选文献并评估文献质量，提取治疗和相关数据后采用RevMan5.3软件进行Meta分析。 结果共纳入符合要求的2篇英文文献和8篇中文文献，总计477例患者。Meta分析结果显示，采用PVP和PKP治疗中国人Kümmell's病时，PKP术后Cobb角（95%CI：0.20～3.47，P = 0.03）、椎体前缘高度（95%CI：-0.87～-0.31，P<0.01）及Oswestry功能障碍指数（95%CI：0.17～1.95，P = 0.02）均明显优于PVP组；PVP仅手术时间少于PKP组（95%CI：-15.82～-8.73，P<0.01）。 结论治疗中国人Kümmell's病时推荐使用PKP，其术后影像学结果（如术后Cobb角及椎体前缘高度等）及临床结果评价（如Oswestry功能障碍指数等）优于PVP技术。

Percutaneous vertebroplasty versus percutaneous kyphoplasty for the treatment of Kümmell's disease in Chinese patients: A systematic review and meta-analysis

ObjectiveCompared the efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of Chinese Kümmell's disease by meta-analysis. MethodsWe performed a systematic literature search across Embase, Pubmed, Central, Cinahl, PQDT, CNKI, CQVIP, WanFang Data, Cochrane Library, and CBM, from October 2008 to October 2018, to compared the efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of Chinese Kümmell's disease. The literature was screened according to inclusion and exclusion criteria and the quality of the literature was assessed strictly. After extracting the data, Statistical software Review manager5.3 was used for data-analysis. ResultsWe included 477 patients from 10 articles (including 2 English articles and 8 Chinese articles). The Cobb angle (95%CI:0.20~3.47, P=0.03), height of vertebral body (95%CI:-0.87~-0.31, P<0.01), and the Oswestry dysfunction index (95%CI:0.17~1.95, P=0.02) in the PKP group were better than that in the PVP group. However, the operation time in the PVP group was less than that in the PKP group (95%CI:-15.82~-8.73, P<0.01). ConclusionPKP is recommended for the treatment of Chinese Kümmell's disease, which is excellent in radiological results (eg. postoperative Cobb angle and vertebral body height, etc.) and clinical outcomes (eg. Oswestry dysfunction index, etc.).