Does Percutaneous Vertebroplasty Improve The Outcome Of Painful Osteoporotic Vertebral Fractures?A Meta-analysis

Objective Osteoporotic vertebral compressed fractures (VCFs) are one of the most common osteoporotic fractures. It was reported percutaneous vertebroplasty (PVP) can relieve the pain of VCFs, and improve the function of spine. However, a recent pooling analysis of two multi-center randomized controlled trials got a result to the contrary. This review are to find out, compared to the conservative therapy and sham injection for VCF patients,(1) Does PVP have a greater pain relief?(2)Does PVP have a greater QOL improvement?(3) And does PVP increase the reoccurrence of fractures?Method We searched PubMed, EMBASE, Medline, and the Cochrane library, and included nine articles identified. We calculated the weighted mean differences (WMDs) to evaluate pain reduction at different time points as the primary outcome. Improvement of QOL and reoccurrence of vertebral fractures were the secondary outcomes.Results Pain scoring was similar between PVP groups and sham injection groups at1to29days and90days. However, compared to the nonoperative therapy, PVP reduced pain at all time points. QOL in the PVP group improved or tended to improve compared to both control groups. The risk of recurrent fractures was similar in the PVP groups and both control groups.Conclusion Different control groups may have accounted for the different assessment on efficacy of PVP in the previous literature. Compared to the nonoperative treatment PVP better relieved pain and improved QOL. PVP did not increase the risk of recurrent fractures.