椎体成形术治疗椎体压缩骨折的荟萃分析

目的：评价椎体成形术治疗椎体压缩骨折的有效性及安全性。方法：电子数据库检索中国期刊全文数据库、中文科技期刊全文数据库、中国生物医学期刊文献数据库、万方数据库及手工检索相关杂志,搜集经皮椎体成形术（PVP）与保守治疗或与经皮椎体后凸成形术（PKP）治疗椎体压缩骨折的临床对照试验,对筛选出的研究进行质量评价,用RevMan 4.2软件对其进行荟萃分析（meta analysis）。结果：最终纳入18个试验,共1 060例患者。三者均能缓解疼痛,PVP与PKP缓解疼痛效果优于保守治疗;1 a后PVP、PKP无差异;PKP优于PVP,0.5 a后,两者效果无差异。在椎体高度恢复及Cobb角矫正上,PVP与保守治疗效果无差异;PKP明显优于PVP。PVP与保守治疗相比,并发症发生率无明显差异,但高于PKP。结论：短期内,PVP缓解疼痛效果优于保守治疗,但不如PKP。PVP在椎体高度恢复、cobb角矫正及安全性方面和保守治疗效果相当,PKP在此方面更有优势,更安全。

Meta Analysis of Percutaneous Vertebroplasty in The Treatment of Vertebral Compression Fractures

Objective：To evaluate the efficacy and safety of percutaneous vertebroplasty（PVP） in the treatment of vertebral compression fractures（VCFs） according to meta analysis.Methods：Collect controlled clinical trials on vertebroplasty and conservative management（CM） or percutaneous kyphoplasty（PKP） for VCFs by computer-based online from CNKI database,VIP database,CBM database and wan fang database and all related journals performed.Evaluate the research by meta analysis with RevMan4.2 software.Results：18 trials met the inclusion criteria,a total of 1060 cases.All the three methods afforded improvement in pain intensity,better than CM.There were no differences after 1year.PKP afforded more pain relief than PVP,no difference after 6months.PVP and CM had similar effect on restoring vertebral height and cobb angle correction.PKP had more effect than PVP.PVP and CM had similar effect on complications rate.PKP had fewer complications rate than PVP.Conclusion：In the short term,PVP had more pain relief than CM but fewer than PKP.PVP had similar effect as CM on restoring vertebral height,cobb angle correction and safety.PKP is superior in these aspects.