Systematic Review and Meta-Analysis of 3 Treatment Arms for Vertebral Compression Fractures

作者：Sascha Halvachizadeh, Anna-Lea Stalder, David Bellut, Sven Hoppe, Philipp Roßbach, Alessandro Cianfoni, Klaus John Schnake, Ladislav Mica, Roman Pfeifer, Kai Sprengel, Hans‐Christoph Pape · 发表于：JBJS Reviews · 年份：2021 · DOI：10.2106/jbjs.rvw.21.00045 · 被引用次数：52 · 研究领域：Spinal Fractures and Fixation Techniques、Bone health and osteoporosis research、Spine and Intervertebral Disc Pathology

BACKGROUND: Osteoporotic vertebral fractures (OVFs) have become increasingly common, and previous nonrandomized and randomized controlled trials (RCTs) have compared the effects of cement augmentation versus nonoperative management on the clinical outcome. This meta-analysis focuses on RCTs and the calculated differences between cement augmentation techniques and nonsurgical management in outcome (e.g., pain reduction, adjacent-level fractures, and quality of life [QOL]). METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the following scientific search engines were used: MEDLINE, Embase, Cochrane, Web of Science, and Scopus. The inclusion criteria included RCTs that addressed different treatment strategies for OVF. The primary outcome was pain, which was determined by a visual analog scale (VAS) score; the secondary outcomes were the risk of adjacent-level fractures and QOL (as determined by the EuroQol-5 Dimension [EQ-5D] questionnaire, the Oswestry Disability Index [ODI], the Quality of Life Questionnaire of the European Foundation for Osteoporosis [QUALEFFO], and the Roland-Morris Disability Questionnaire [RDQ]). Patients were assigned to 3 groups according to their treatment: vertebroplasty (VP), kyphoplasty (KP), and nonoperative management (NOM). The short-term (weeks), midterm (months), and long-term (>1 year) effects were compared. A random effects model was used to s...