椎体后凸成形术与椎体成形术治疗骨质疏松性椎体压缩骨折的Meta分析

目的:用Meta分析的方法评价椎体后凸成形术(percutaneous kyphoplasty,PKP)与椎体成形术(percu-taneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的疗效及安全性。方法:计算机检索1997年1月～2011年1月的Ovid medline数据库、Web of science数据库、EMbase数据库及Cochrane central register of controlled trial(2011年第1期),手工检索相关杂志,搜集关于PKP与PVP治疗骨质疏松性椎体压缩骨折疗效比较的对照研究。按纳入和排除标准筛选文献,评价文献质量后采用RevMan 5.0.25进行数据分析。结果:最终纳入9个非随机前瞻性对照试验,1个随机对照试验,共749例患者。两组(PKP组及PVP组)病例术后疼痛症状均得到缓解,随访1年内患者,PKP组疼痛缓解效果略高于PVP组(P<0.05);随访大于1年者,PKP组效果明显高于PVP组(P<0.05);两组病例术后疼痛功能障碍均得到缓解,但两组间效果无明显差异(P>0.05)。大多数研究表明PVP组在矫正畸形和恢复椎体高度方面更有优势(P<0.05),但亦有部分研究认为2组间无差异性(P>0.05);两组病例在生活质量改善上效果相似(P>0.05);两组病例术后并发症发生率上PKP组小于PVP组(P<0.05)。结论:PKP在缓解疼痛、增加椎体高度及纠正畸形方面较PVP更有优势,且更为安全,但不能完全否定PVP的作用。

Kyphoplasty versus vertebroplasty for osteoporotic vertebral compression fracture:a Meta analysis

Objective:To evaluate the efficacy and safety of kyphoplasty versus vertebroplasty for osteoporotic vertebral compression fracture(OVCF).Method:A systematic computer-based search(from Jan 1997 to Jan 2011)of Ovid medline,Web of science,EMbase,Cochrane central register of controlled trial(Issue 1 of 4,2011) and manual search of related journals were performed for collecting controlled trials on kyphoplasty and vertebroplasty for OVSF.The included trials were screened based on the inclusion and exclusion crit...