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The Systematic Review for Two Kinds of Minimally Invasive Surgical Treatment of Vertebral Compression Fractures

Author: ZuoLiang
Tutor: HanShuFeng
School: Shanxi Medical
Course: Orthopaedic Surgery
Keywords: After percutaneous vertebroplasty Kyphoplasty Vertebral fractures System Evaluation
CLC: R687.3
Type: Master's thesis
Year: 2010
Downloads: 173
Quote: 1
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Abstract

Background: Percutaneous vertebroplasty the angioplasty and kyphoplasty is a minimally invasive surgical method recommended for the treatment of osteoporotic vertebral compression fractures, their pain relief, the effectiveness of the reinforcement of the vertebral body and to maintain the stability of the spine has been clinically certainly . At present the main problems of the two treatment methods filler leakage, recurrent fractures and adjacent vertebral fractures caused by security problems. As the two surgical methods have their advantages and disadvantages, and they have been the different doctors selective application, there is a lack of valid evidence that that way is more effective and safer. Objective: systematic reviews of this article has been published at home and abroad for percutaneous vertebroplasty and kyphoplasty treatment of osteoporotic vertebral compression fracture randomized controlled trial of the efficacy and safety of research for clinical decision-making and Next direction provide some evidence. Methods: computer search ended in December 2009, the MEDLINE, EMBASE, the Cochrane Library, CNKI literature databases, hand searches Spine, \randomized controlled trials and clinical trials, one by one to evaluate the quality of Remvan system evaluation software into Meta-analysis. Results: A total of 14 to meet the requirements of the experimental. Meta-analysis of the results showed that the VAS score (1) PVP and PKP 48 hours after WMD value -0.15,95% CI (-0.30, -0.00), and follow-up the terminal VAS score WMD is -0.08,95% CI (-0.22,0.05) (P values ??are gt; 0.05), the difference was not statistically significant; (2) two minimally invasive surgery follow-up in patients with terminal vertebral height restoration WMD value of -18.49 95% CI (-21.16, -15.42), the difference was statistically significant (P lt; 0.05); (3) two kinds of minimally invasive surgical techniques for patient follow-up terminal / Cobb angle of kyphosis WMD value of 5.01 , 95% CI (4.31,5.71), the difference was statistically significant (P lt; 0.05); (4) PVP and PKP postoperative value for patients with spinal function improvement (ODI) WMD 0.87,95% CI (0.52 , 1.22), a statistically significant difference (P lt; 0.05); (5) after the two kinds of minimally invasive surgical bone cement leakage in the event of the occurrence of the difference was not statistically significant, OR = 0.89,95% CI (0.54,1.45 ), related to serious complications such as pulmonary embolism, and nerve damage bone cement leakage incidents differences statistically significant OR = 2.68,95% CI (0.53,13.48) (P values ??gt; 0.05); (6) two kinds of minimally invasive surgery adjacent vertebral fracture events occurred OR value of 0.51,95% CI (0.20,1.26), the difference was not statistically significance (P gt; 0.05). Conclusion: The current study: (1) PVP and of PKP after 48 hours and follow-up terminal can significantly ease the patient's pain, the difference was not statistically significant; (2) the PKP group compared to the PVP group restore compressed vertebral there are advantages for the height of the body leading edge, the difference was statistically significant; (3) the PKP group in the recovery of kyphosis / Cobb angle there advantages compared to the PVP group, the difference was statistically significant; (4) PKP group for patients with spinal functional improvement than the PVP group, the difference was statistically significant; (5) of two procedures in the event of the occurrence of the leakage of bone cement, cement leakage and pulmonary embolism, and nerve injury related serious complications incident no statistical difference significance; (6) adjacent vertebral fracture events occurred after two minimally invasive surgery difference was not statistically significant; (7) due to the inclusion of the presence of the high degree of selection bias and measurement bias may be, is bound to be evidence of the results of this study The intensity of a certain impact, and therefore look forward to more high-quality random double-blind controlled trials to provide solid evidence.

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