保守疗法和椎体成形术治疗骨质疏松性椎体压缩骨折的系统评价

[目的]评价保守疗法和经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效.[方法]全面收集保守疗法和PVP治疗骨质疏松性椎体压缩骨折的随机对照研究,在严格文献质量评价的基础上,进行系统评价.[结果]共纳入4篇RCT,共计285例患者.在减轻疼痛方面,经皮椎体成形术组在术后ld、2周均优于保守组.在再骨折和邻椎骨折方面,尚不能得出确切结论.[结论]经皮椎体成形术和保守疗法均是治疗骨质疏松性椎体压缩骨折的有效治疗方法,近期疼痛缓解情况经皮椎体成形术组优于保守组,再骨折的评价缺乏足够的证据,尚需更多设计严谨的临床试验证实.

Conservative treatment and percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures:a systematic review

[Objective]To evaluate the efficacy and safety of conservative treatment and percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures(OVCF). [Method]All randomized controlled trials of conservative treatment and percutaneous vertebroplasty for the treatment of OVCF were identified.The methodological quality of included studies was evaluated,then a systematic review was made. [Result]Four studies including a total of 285 patients met the inclusion criteria.Compared with conservative treatment,percutaneous vertebroplasty was associated with less pain on the first day and within two weeks,but there was no greater improvement in long term.For the risk of new adjacent vertebral fractures,there was no difference between both methods for lack of evidence. [Conclusion]Both percutaneous vertebroplasty and conservative treatment appeared to produce comparable long term outcomes for treatment of OVCF.Percutaneous vertebroplasty had a significantly greater improvement in pain scores within 2 weeks.The risk of new fractures can not be evaluated for lack of evidence.High-quality randomized trials are needed to confirm this.