[1]孙晗 杨惠林 孙佳佳 刘义杰 杨旭 孙思炜 周峰 孟斌.对比单双侧椎体后凸成形术治疗骨质疏 松性椎体压缩性骨折的Meta 分析[J].中华老年骨科与康复电子杂志,2015,(02):39-47.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .008]
 Sun Han,Yang Huilin,Sun Jiajia,et al.Unilateral versus bilateral percutaneous kyphoplasty in treating osteoporotic vertebral compression fractures: A systematic review and meta-analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(02):39-47.[doi:10.3877/cma.j.issn.2096-0263.2015.02 .008]
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对比单双侧椎体后凸成形术治疗骨质疏 松性椎体压缩性骨折的Meta 分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2015年02期
页码:
39-47
栏目:
综述
出版日期:
2015-11-05

文章信息/Info

Title:
Unilateral versus bilateral percutaneous kyphoplasty in treating osteoporotic vertebral compression fractures: A systematic review and meta-analysis
作者:
孙晗 杨惠林 孙佳佳 刘义杰 杨旭 孙思炜 周峰 孟斌
苏州大学附属第一医院骨科
Author(s):
Sun Han Yang Huilin Sun Jiajia Liu Yijie Yang Xu Sun Siwei Zhou Feng Meng Bin
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
关键词:
骨折压缩性 椎体成形术 Meta 分析 随机对照试验 骨质疏松症
Keywords:
Fractures compression  Kyphoplasty  Meta-analysis  Randomized controlled trial Osteoporosis
DOI:
10.3877/cma.j.issn.2096-0263.2015.02 .008
摘要:
目的 利用Meta 分析的方法评价单侧与双侧入路经皮椎体后凸成形术治疗骨质疏松 性椎体压缩性骨折的疗效和安全性。方法 采用了PubMed MEDLINE、EMBASE、Web of Science 及 Cochrane Library 等互联网搜索引擎作为检索工具,系统检索了从1900 年1 月至2015 年7 月有关比较 单侧与双侧入路经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的文献。纳入文献需为有关两种治 疗方式对比的随机对照试验。文献筛选、纳入及数据提取工作由2 名研究者独立完成,并用RevMan 5.3 软 件进行统计学分析。结果 共6 篇文献563 例患者纳入本Meta 分析。分析结果表明单侧入路的手术时 间短(MD:-23.19;95% CI: -27.08 ~ -19.31;P < 0.001),骨水泥用量少(MD:-2.07; 95% CI: -2.23 ~ -1.91;P < 0.001),术后骨水泥渗漏率也低(RR :0.59;95% CI:0.35 ~ 0.99; P < 0.05)。而两种手术入路在视觉模拟量表评分(短期及长期随访)、Oswestry 功能障碍指数(中 期及长期随访)、后凸角恢复、椎体前高度恢复率、椎体高度丢失率、术后临近节段骨折等方 面差异无统计学意义。结论 两种入路都是治疗骨质疏松性椎体压缩性骨折安全及有效的手术方式。 然而,单侧入路具有手术时间短、骨水泥渗漏率低、骨水泥使用量及辐射剂量少等优点。
Abstract:
 Objective The objective of this study was to compare the efficacy and safety of unipedicular kyphoplasty and bipedicular kyphoplasty in treating ostcoporotic vertebralcoression fractures (OVCFs) using Meta-analysis. Methods Studies comparing between unilateral kyphoplasty and bilateral kyphoplasty in treating OVCFs with randomized controlled trials were searched systematically in PubMed MEDLINE, EMBASE, Web of Science, and Cochrane Library, from January 1990 to June 2015. The work of screening, inclusion of articles and data extraction were performed by two researchers independently. The RevMan 5.3 programme was used to carry out the meta-analysis. Results Six articles with 563 patients were enrolled in this study. The results showed that the unilateral approach possessed less surgery time (MD: -23.19; 95% CI: -27.08 ~ -19.31; P<0.001) and cement consumption (MD: -2.07; 95% CI: -2.23 ~ -1.91; P<0.001), as well as less cement leakage ratio (RR: 0.59; 95% CI: 0.35 ~ 0.99; P<0.05). No significant differences were found in the visual analog scale score (short-term and long-term), Oswestry disability index score (mid-term and long-term), kyphotic angle reduction, restoration rate of anterior vertebral height, vertebral height loss rate, and postoperative adjacent-level fractures. Conclusion Both unilateral kyphoplasty and bilateral kyphoplasty are safety and effective selections for OVCFs. However, unilateral kyphoplasty may be more recommended considering that it has the advantage of shorter operation time, lower cement leakage rate, less cement usage and radiation dose.

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更新日期/Last Update: 2015-12-30