目的:系统评价椎体支架成形术(vertebral body stenting，VBS)和经皮椎体后凸成形术(percutaneous kyphoplasty，PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture，OVCF)的有效性和安全性。方法:应用计算机检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、Web of Science、Embase和Cochrane Library中VBS和PKP治疗OVCF的对比研究文献，检索时限均为建库起至2023年12月20日。试验组采用VBS治疗，对照组采用PKP治疗，且均采用双侧椎弓根入路。2名研究人员分别独立进行文献筛选、数据提取和纳入研究的质量评价。采用Stata18。0软件进行Meta分析。结果:共检索到196篇文献，最终纳入10篇文献，共涉及707例患者，其中试验组353例、对照组354例。Meta分析结果显示，试验组的手术时间长于对照组[WMD=9。02，95％CI(2。72，15。32)，P=0。005]，骨水泥填充量多于对照组[WMD=1。00，95％CI(0。34，1。65)，P=0。003]，术后伤椎后凸 Cobb 角、局部后凸 Cobb 角均小于对照组[WMD=-3。16，95％CI(-5。22，-1。10)，P=0。003;WMD=-1。87，95％CI(-2。11，-1。64)，P=0。000]，术后 Beck 指数大于对照组[WMD=0。16，95％CI(0。11，0。20)，P=0。000]，2组术中出血量、住院时间、骨水泥渗漏发生率、其他不良事件发生率的差异均无统计学意义[WMD=0。19，95％CI(-0。18，0。55)，P=0。317;WMD=0。09，95％CI(-0。12，0。29)，P=0。410;RR=0。96，95％CI(0。69，1。32)，P=0。799;RR=0。39，95％CI(0。06，2。34)，P=0。301]。结论:现有证据表明，VBS手术时间长于PKP，骨水泥填充量多于PKP，在恢复和维持伤椎正常形态方面优于PKP，二者在术中出血量、住院时间及安全性方面相当。
Clinical outcomes and safety of vertebral body stenting versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta-analysis
Objective:To systematically review the clinical outcomes and safety of vertebral body stenting(VBS)versus percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:All the comparative study articles about VBS versus PKP for treatment of OVCF included from database's inception to December 20,2023 were retrieved from the China National Knowledge Infrastructure,Wanfang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Web of Science,Em-base and Cochrane Library through computer.The patients in experiment group were treated with VBS through bipedicular approach,while the ones in control group with PKP through bipedicular approach.The articles were screened,the information was extracted and the methodological quality of included researches in the articles was evaluated independently by two researchers,and then a Meta-analysis was conducted by using Stata18.0 software.Results:One hundred and ninety-six articles were searched out.After screening,10 articles(707 pa-tients)were included in the final analysis,353 patients in experiment group and 354 ones in control group.The results of Meta-analysis re-vealed that the operative time was longer,the consumption of bone cements was more,the postoperative injured vertebrae kyphosis Cobb's angle and local kyphosis Cobb's angle were smaller,the postoperative Beck index was greater in experiment group compared to control group(WMD=9.02,95％CI(2.72,15.32),P=0.005;WMD=1.00,95％CI(0.34,1.65),P=0.003;WMD=-3.16,95％CI(-5.22,-1.10),P=0.003;WMD=-1.87,95％CI(-2.11,-1.64),P=0.000;WMD=0.16,95％CI(0.11,0.20),P=0.000);while,there was no statistical difference in intraoperative blood loss,hospital stay,incidence rate of bone cement leakage and adverse events between the 2 groups(WMD=0.19,95％CI(-0.18,0.55),P=0.317;WMD=0.09,95％CI(-0.12,0.29),P=0.410;RR=0.96,95％CI(0.69,1.32),P=0.799;RR=0.39,95％CI(0.06,2.34),P=0.301).Conclusion:Available evidences suggest that VBS consumes more operative time and bone cements compared to PKP,while,it outperforms PKP in restoring and maintaining the normal morphology of injured vertebra.However,the both are comparable in intraoperative blood loss,hospital stay,and safety.
spinal fracturesosteoporotic fracturesfractures,compressionkyphoplastyvertebral body stentingmeta-analysis as topic
万方数据
维普
