Percutaneous Curved Vertebroplasty and Bilateral-Pedicle-Approach Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fracture: A Meta-Analysis

• Published in: Geriatric orthopaedic surgery & rehabilitation Vol. 14; p. 21514593231182533
• Main Authors: He, Yanxing, Yu, Zhentang, Yin, Jianjian, Wang, Hao, Xu, Nanwei, Nong, Luming, Jiang, Yuqing
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-01-2023; Sage Publications Ltd; SAGE Publishing
• Subjects: Original Manuscript; Polymethyl methacrylate; Systematic review; bone cement; meta-analysis; percutaneous curved vertebroplasty procedure; osteoporotic vertebral compression fracture; bilateral-pedicle-approach percutaneous vertebroplasty
• ISSN: 2151-4593; 2151-4585; 2151-4593
• DOI: 10.1177/21514593231182533

Introduction
The aim of this study was to evaluate the use of percutaneous curved vertebroplasty procedure (PCVP) and bilateral-pedicle-approach percutaneous vertebroplasty (bPVP) for the treatment of osteoporotic vertebral compression fractures (OVCFs) through a systematic review and meta-analysis of the scientific literature.
Methods
A systematic review of the scientific literature in PubMed, China National Knowledge Infrastructure (CNKI), Wanfang and other databases was conducted in conjunction with different keywords. Nine studies were included; all but 3 were randomised controlled studies and all were prospective or retrospective cohort studies.
Results
We observed statistically significant differences between the PCVP group and the bPCVP group in terms of postoperative visual analogue scale (VAS) scores (mean difference [MD]: −.08; 95% confidence intervals [CI]: −.15 to .00), bone cement leakage rates (OR = .33; 95%CI: .20 to .54), bone cement injection (MD: −1.52; 95%CI: −1.58 to 1.45), operative times (MD: −16.69; 95%CI: −17.40 to −15.99) and intraoperative fluoroscopies (MD: −8.16; 95%CI: −9.56 to −6.67), with the PCVP group being more dominant. There were no statistical differences in postoperative Oswestry Disability Index (ODI) scores (MD: −.72; 95%CI: −2.11 to .67) and overall bone cement distribution rates (MD: 2.14; 95%CI: .99 to 4.65) between the 2 groups.
Conclusions
Meta-analysis showed more favourable outcomes in the PCVP group compared to the bPVP group. PCVP might be effective and safe in the treatment of OVCFs because it relieves postoperative patient pain, reduces operative time and cement injection, and decreases the risk of cement leakage and radiation exposure to the surgeon and patient.