Comparison Between Percutaneous Kyphoplasty And Percutaneous Vertebroplasty In Terms of The Efficacy For Osteoporotic Vertebral Compression Fractures: A Meta-Analysis

Abstract

Background & Aim: Osteoporotic vertebral compression fractures (OVCFs) are acknowledged as common occurred fractures among humans, especially for the elderly population. The minimally invasive percutaneous methods such as kyphoplasty as well as vertebroplasty have been valid and effective tools in terms of reducing clinical problems, which are associated with more beneficial effects as compared to traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence available for the systematical assessment of the clinical and radiographic outcomes of VP in comparison of KP.Methods: Publications on comparison kyphoplasty versus vertebroplasty in treatment of OVCFs were collected. After rigorous and thorough review of quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the endpoints of interested.Results: Totally, our inclusion criteria involved five studies. 561subjects involving 334 patients received VP and 227 patients received KP were included, of which patients receiving KP or VP failed to show any significant differences in the visual analog scale (VAS) scores (MD =-0.02, 95% CI -0.40 – 0.35; P = 0.91),and the risk of cement leakage (OR =1.60, 95% CI 0.82 – 3.12; P = 0.17). Nevertheless, the Oswestry Disability Index (ODI) scores (MD =-1.56, 95% CI -2.39 – -0.73; P = 0.0002), the injected cement volume (MD =-0.40, 95% CI -0.77 – -0.04; P = 0.03) and the operation time (MD =-9.67, 95% CI -11.55 – -7.80; P ＜0.00001) in VP group were linked to markedly lower trend in comparison of KP group with significant statistical difference.Conclusion: The present meta-analysis controls the acceptable level of the efficacy across the involved trials. The VP had ODI scores, the injected cement volume and the operation time exerted several advantages in this meta-analysis. Yet, VP failed to show benefits in terms of the VAS scores and cement leakage in comparison of KP therapy. Given the combined results of our study, the optimal treatment for patient harboring OVCFs should be determined by further high-quality and multi-center RCTs along with longer follow-ups as well as larger sample size.

Efficacy and safety of oral traditional Chinese medicine combined with conventional anti-osteoporosis drugs for osteoporosis and fractures: A meta-analysis of randomized controlled trials

“…9 studies [21,30,35,36,53,[55][56][57][58] reported the T-score of 1543 patients after treatment in 2 groups, including 772 patients in the observation group and 771 patients in the control group. After subgroup meta-analysis, the heterogeneity test (I² = 96.2%, P < .00001) indicated significant heterogeneity among the studies, and subgroup analysis was required.…”

Treatment for Osteoporotic Vertebral Fracture - A Short Review of Orthosis and Percutaneous Vertebroplasty and Balloon Kyphoplasty

“…Further high-quality multicenter randomized controlled trials with longer follow-up and larger sample sizes are needed, but at this time indicate that there are no significant differences between PVP and BKP in terms of VAS score, ODI score, or cement leakage, and that both are useful treatments for patients with OVF [ 25 - 34 ].…”

“…Further high-quality multicenter randomized controlled tri-als with longer follow-up and larger sample sizes are needed, but at this time indicate that there are no significant differences between PVP and BKP in terms of VAS score, ODI score, or cement leakage, and that both are useful treatments for patients with OVF. [25][26][27][28][29][30][31][32][33][34] On the other hand, a systematic review comparing BKP and PVP, focusing on the primary outcome of height restoration and the secondary outcomes of pain relief and function (33 total randomized controlled trials; 20 BKP, 7 PVP, and 6 comparing PVP to BKP), suggested that BKP may be superior in restoring vertebral height, but both procedures restored some vertebral height reduction, kyphosis, Cobb angle, and wedge angle, and showed benefit in pain reduction and patient-reported functional improvement. However, it is not possible to definitively conclude whether BKP or PVP is superior in reducing pain and restoring function because many studies that examined all 3 variables did not report statistically significant results, and more definitive studies and data analysis are needed to confirm this finding (Figs.…”

Percutaneous mesh-container-plasty versus percutaneous kyphoplasty in the treatment of osteoporotic compression fractures with up-endplate injury: a retrospective study

“…[1]Osteoporosis has become more prevalent in the elderly population due to decreased bone density and bone quality, microstructural damage, and increased bone fragility, resulting in systemic bone diseases prone to fractures. [2][3][4] One common complication of osteoporosis in the elderly is osteoporotic vertebral compression fractures (OVCF). OVCF often occurs in the thoracolumbar region of elderly individuals with osteoporosis, causing signi cant pain and limited mobility, severely impacting the quality of life.…”