Meta-Analysis Of The Efficacy Of Percutaneous Curved Vertebroplasty And Bilateral Pedicle Approach Percutaneous Vertebroplasty In The Treatment Of Osteoporotic Vertebral Compression Fracture

Objective:As a new bone cement augmentation technique,the clinical application of curved vertebroplasty is limited,and its efficacy remains to be verified.In this paper,we compared the efficacy of curved vertebroplasty and bilateral pedicle vertebroplasty in the treatment of osteoporotic vertebral compression fractures in Chinese population by meta-analysis.Method:Searching Pub Med,Cochrane library,Medline,Web of science,Wanfang,CNKI and other databases through computer,and finding unpublished related literature through other channels.Retrieving clinical controlled trials in the treatment of osteoporotic vertebral compression fractures with curved angle and bilateral pedicle approach vertebroplasty.Only relevant literatures in Chinese and English are retrieved.The search period is from the establishment of the database to February2021.Formulate relevant inclusion and exclusion criteria to screen the literature,and perform quality evaluation according to the characteristics of the literature,extract the relevant data,and use the Review Manager 5.3 software for analysis.The evaluation indicators of this study mainly include: operation time,X-ray fluoroscopy,blood loss,bone cement usage,bone cement leakage rate,ideal bone cement distribution rate,kyphosis recovery rate,postoperative VAS score,postoperative ODI score.Results:A total of 14 articles were included in this study,with a total of 1030 cases,including 501 cases in the PCVP group and 529 cases in the BVP group.Meta analysis results showed that the PCVP group can shorten the operation time[MD=-16.55,95%CI is(-17.09,-16.01),p<0.00001],and reduce the number of intraoperative X-ray fluoroscopy [MD=-7.98,95%CI Is(-9.24,-6.73),p<0.00001],reduces surgical bleeding [MD=-3.60,95%CI is(-4.11,-3.10),p<0.00001],reduces bone cement usage [MD=-1.52,95%CI is(-1.59,-1.45),p<0.00001],reduce bone cement leakage rate [OR=0.51,95%CI is(0.36,0.71),p<0.0001],improve the ideal distribution rate of bone cement [OR=2.36,95%CI is(1.17,4.76),p=0.02],reduce the VAS score within 1 week after surgery [MD=-0.18,95%CI is(-0.18,-0.03),p=0.006],Reduce the VAS score 3 months after surgery [MD=-0.17,95%CI is(-0.26,-0.08),p=0.0001],however,the recovery rate of the Cobb angle of the injured vertebrae after surgery,the ODI score within 1 week after surgery And the ODI score at 3 months after operation(p>0.05),there was no significant difference between the PCVP group and the BVP group.Conclusion:This study shows that the PCVP group can significantly shorten the operation time,reduce the number of intraoperative X-ray fluoroscopy,reduce the amount of surgical bleeding,reduce the amount of bone cement used,reduce the leakage rate of bone cement,increase the ideal distribution rate of bone cement,and reduce 1 week after surgery There was no significant difference between the PCVP group and the BVP group in terms of internal VAS score,reduction of VAS score at 3 months after surgery,etc.,the recovery rate of Cobb angle of injured vertebrae after surgery,ODI score within 1 week after surgery,and ODI score at 3 months after surgery.Due to the uneven quality of the included literature and the limitation of the sample size in each study,and the large differences in the literature design,the conclusions in this study still need to be confirmed by multi-center,high-quality clinical RCTs.