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

被引：27

作者：

朱佳俊

屠冠军

机构：

[1] 中国医科大学附属第一医院骨科

来源：

中国脊柱脊髓杂志 | 2011年 / 21卷 / 10期

关键词：

椎体后凸成形术; 椎体成形术; 骨质疏松症; 椎体压缩骨折; Meta分析;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

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。

引用

页码：848 / 852

页数：5

共 14 条

[1]

A Comparative Analysis of the Results of Vertebroplasty and Kyphoplasty in Osteoporotic Vertebral Compression Fractures.[J].Krishna Kumar;Rita Nguyen;Sharon Bishop.Neurosurgery.2010, 3 Op

[2]

Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a comparison of balloon kyphoplasty and vertebroplasty [J].

Movrin, I. ;

Vengust, R. ;

Komadina, R. .

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2010, 130 (09) :1157-1166

[3]

Effectiveness; Security and Height Restoration on Fresh Compression Fractures – A Comparative Prospective Study of Vertebroplasty and Kyphoplasty.[J].M. R?llinghoff;J. Siewe;K. Zarghooni;R. Sobottke;Y. Alparslan;P. Eysel;K.-S. Delank.Minim Invasive Neurosurg.2009, 05/0

[4]

Comparison of kyphoplasty and vertebroplasty in the treatment of fresh vertebral compression fractures [J].

Schofer, Markus Dietmar ;

Efe, Turgay ;

Timmesfeld, Nina ;

Kortmann, Horst-Rainer ;

Quante, Markus .

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2009, 129 (10) :1391-1399

[5]

Balloon kyphoplasty versus vertebroplasty for treatment of osteoporotic vertebral compression fracture: a prospective, comparative, and randomized clinical study [J].

Liu, J. T. ;

Liao, W. J. ;

Tan, W. C. ;

Lee, J. K. ;

Liu, C. H. ;

Chen, Y. H. ;

Lin, T. B. .

OSTEOPOROSIS INTERNATIONAL, 2010, 21 (02) :359-364

[6]

Vertebroplasty and kyphoplasty: complementary techniques for the treatment of painful osteoporotic vertebral compression fractures. A prospective non-randomised study on 154 patients [J].

Alessio Lovi ;

Marco Teli ;

Alessandro Ortolina ;

Francesco Costa ;

Maurizio Fornari ;

Marco Brayda-Bruno .

European Spine Journal, 2009, 18 :95-101

[7]

Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature [J].

Eck, Jason C. ;

Nachtigall, Dean ;

Humphreys, S. Craig ;

Hodges, Scott D. .

SPINE JOURNAL, 2008, 8 (03) :488-497

[8]

Comparison of therapeutic effect between percutaneous vertebroplasty and kyphoplasty on vertebral compression fracture.[J].Jian-lin Zhou;Shi-qing LIU;Jiang-hua Ming;Peng Hao;Bo QIU.Chinese Journal of Traumatology (English Edition).2008, 1

[9]

Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation procedures - A nonrandomized comparison between vertebroplasty and kyphoplasty [J].