Unipedicular Versus Bipedicular Percutaneous Vertebroplasty For Osteoporotic Vertebral Compression Fractures: A Meta Analysis

Objective:To evaluate the efficacy and safety of unipedicular percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures(OVCFs)compared with that of bipedicular treatment.Methods:A systematic computer-based search(from Jan 1987 to Dec 2016)of PubMed,Springer,EMBASE,OVID,Web of science,Cochrane central register of controlled trial,CNKI,WanFang Data.Manual search《Spine》,《Euro Spine》,《Chinese Journal of Orthopaedics》,《Chinese Journal of Spine and Spinal Cord》.Heterogeneities analysis and bias analysis for the articles included were conducted.Review Manager 5.3 was adopted to estimate the effects of the results among selected articles.Results:The results showed that compared with bipedicular,the unipedicular had a poorer outcome of VAS scores in 3 months follow-up time in the subgroup analysis(Z=2.47,P=0.01).There was no significant statistical difference in the others subgroup.The total results also showed that the VAS scores of unipedicular had a poorer outcome(Z=2.93,P=0.003).The QUALEFFO score of unipedicular were more than bipedicular in 3,6,12 months follow-up time(Z=5.81,P<0.00001).There was no significant difference of ODI score,and cement leakage rate(P=0.65).The surgery time of unipedicular is much less than that of bipedicular(P<0.00001).Patients with bipedicular have been injected more cement than unipedicular(P<0.00001).Conclusion:Both unipedicular and bipedicular could lead to quick pain relief and improvement of life quality in patients after percutaneous vertebroplasty.Unipedicular is superior in pain relief and the quality life in the long-term follow-up.