Meta-analysis of percutaneous kyphoplasty for elderly osteoporotic vertebral compression fractures

• Main Authors: Li Kai-Ming, Li Ling-Hui, Wang Shang-Quan, Zhang Qing, Yin Jing, Hou Xiao-Zhou
• Format: Article
• Language: English
• Published: Editorial Board of Journal of Hainan Medical University 2019-08-01
• Series: Journal of Hainan Medical University
• Subjects: percutaneous kyphoplasty; pkp; osteoporotic vertebral compression; fractures; ovcf
• Online Access: http://www.hnykdxxb.com/PDF/201915/10.pdf
• ISSN: 1007-1237; 1007-1237

Objective: To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF) in the elderly by metaanalysis, and to provide a basis for clinical application. Methods: CNKI, Wanfang, Weipu, CBM, PubMed, the Cochrane Library and EMbase were retrieved by computer from the date of establishment to January 2019. The literature on randomized controlled trials of PKP and conservative treatment of OVCF was collected and diagnosed as thoracolumbar vertebral compression fracture by X-ray, CT, and MRI. Osteoporosis of thoracolumbar vertebrae (T<2.5) was determined by bone mineral density measurements. Age (>50 years old) and course of the disease (< 3 months). Postoperative outcome indicators included at least one of the following indicators: visual analogue scale. VAS and Oswestry Dysfunction Index (ODI), changes of Cobb angle of diseased vertebrae and height of the anterior edge of diseased vertebrae. The quality of the included literature was evaluated by referring to the evaluation criteria for randomized controlled trials provided in the Cochrane Systematic Evaluation Manual. Results: Six randomized controlled trials studies were included, all of which were Chinese literature. Five of them had 4 or more points in methodological quality evaluation and one had 3 points in methodology quality evaluation. There were 525 patients in the two groups, 267 in the PKP group and 258 in the conservative treatment group. Meta-analysis showed that the pain visual analogue score in the PKP group was significantly higher than that in the conservative treatment group [MD=2.10, 95%CI(-2.25, -1.95), P<0.00 001]. There were significant differences between the PKP group and the conservative treatment (CT) group [MD=8.90, 95%CI (-9.86, -7.94), P<0.00 001] in the changes of the Cobb angle of the diseased vertebrae after treatment. There were significant differences in the ODI and the height of the anterior edge of the diseased vertebrae (P<0.05). Conclusion: PKP treatment of OVCF can effectively reduce pain visual analogue score, improve dysfunction index (ODI) and improve the quality of life of patients. It can also effectively restore the height of vertebral loss, correct the Cobb angle of the diseased vertebrae, and reduce the risk of recurrent fracture of the adjacent vertebral body and serious complications.