Unipedicular versus bipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures:a meta-analysis

Yin Le-le; Xu Xiao-xiong; Pan Qi-lin; Zuo Kang-kang

doi:10.3969/j.issn.2095-4344.2014.31.019

Abstract：BACKGROUND:Percutaneous kyphoplasty, as a kind of minimal y invasive surgery, has been proved to be effective in the treatment of osteoporotic vertebral compression fractures. Percutaneous kyphoplasty has simple operation and safe mode, can relieve pain quickly, and obviously restore vertebral body height. However, the therapeutic effects of unipedicular and bipedicular percutaneous kyphoplasty for osteoporotic vertebral compression fractures are controversial. <br> OBJECTIVE:To analyze control ed trials on the therapy with unipedicular and bipedicular percutaneous kyphoplasty using meta-analysis, and to compare the effectiveness and superiority of the two methods with a large sample size. <br> METHODS:We retrieved PubMed, Web of Knowledge, China Journal Ful-text database, Wanfang database, and Super Star database for articles on meta-analysis of unipedicular versus bipedicular percutaneous kyphoplasty published from 2000 to 2014 in Chinese and English. Unipedicular percutaneous kyphoplasty served as experimental group and bipedicular percutaneous kyphoplasty as control group. Curative effect and the difference between evaluation indexes were expressed as the weighted mean difference and 95%confidence interval and the RR value. Statistical analysis was carried out using Review Manager 5.2 software. <br> RESULTS AND CONCLUSION:A total of seven randomized control ed trials were col ected. Results of statistical analysis showed that visual analogus scale scores were decreased in both groups, but no significant difference was detected [RR=-0.08, 95%CI(-0.05,-0.21), P=0.21]. There was no significant difference in Cobb angle change [RR=-0.07, 95%CI(-0.16,-1.47), P=0.93]. No significant difference in the average recovered height of vertebral bodies was detected [RR=-1.76, 95%CI(-4.21, -0.69), P=0.16]. Operation time was shorter in unipedicular percutaneous kyphoplasty than in bipedicular percutaneous kyphoplasty [RR=-23.99, 95%CI(-26.01, -21.97), P<0.000 01]. These data indicated that compared with bipedicular percutaneous kyphoplasty, unipedicular percutaneous kyphoplasty could effectively reduce the operation time. However, no significant difference in visual analogus scale scores, Cobb angle change and the average recovered height of vertebral bodies was visible in statistical analysis in both groups.