[1]唐振坤,俞桂松,范奕松,等.骨填充网袋椎体成形术与经皮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].中医正骨,2019,31(10):31-36.
　TANG Zhenkun,YU Guisong,FAN Yisong,et al.Comparison of bone filling mesh container vertebroplasty versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(10):31-36.
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骨填充网袋椎体成形术与经皮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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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年10期
页码:
31-36
栏目:
文献研究
出版日期:
2019-10-20

文章信息/Info

Title:
Comparison of bone filling mesh container vertebroplasty versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta analysis
作者:
唐振坤1; 俞桂松1; 范奕松1; 蒋瑛翘1; 王艺超2; 刘晋闽3
(1.浙江中医药大学第一临床医学院,浙江 杭州 310053; 2.汝阳县人民医院,河南 汝阳 471200; 3.浙江省中医院,浙江 杭州 310006)
Author(s):
TANG Zhenkun1; YU Guisong1; FAN Yisong1; JIANG Yingqiao1; WANG Yichao2; LIU Jinmin3
1.The First Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China 2.The People's Hospital of Ruyang county,Ruyang 471200,Henan,China 3.Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310006,Zhejiang,China
关键词:
骨折; 压缩性;  骨质疏松性骨折;  椎体后凸成形术;  骨填充网袋;  Meta分析;  系统评价
Keywords:
fractures; compression;  osteoporotic fractures;  kyphoplasty;  bone filling mesh container;  meta-analysis;  systematic review
摘要:
目的:比较骨填充网袋(bone filling mesh container,BFMCs)椎体成形术与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效和安全性。方法:应用计算机检索万方、中国知网、维普、中国生物医学文献数据库、Pubmed数据库从建库至2019年5月15日国内外公开发表的BFMCs椎体成形术(治疗组)与PKP(对照组)治疗OVCF的随机对照临床研究或回顾性临床研究文献。由2名研究者根据纳入和排除标准独立筛选文献并提取资料,采用纽卡斯尔-渥太华量表(the Newcastle-Ottawa scale,NOS)评价纳入研究的文献质量,采用RevMan5.3软件进行Meta分析。结果:最初检索出51篇文献,通过阅读标题和摘要后剔除重复文献30篇,剩余21篇经过通读全文后,最终纳入5篇文献,均为中文文献。1篇文献比较了BFMCs椎体成形术、PKP、经皮椎体成形术治疗OVCF的疗效,其余4篇文献均比较BFMCs椎体成形术和PKP治疗OVCF的疗效。5篇文献共涉及398例患者、443个伤椎,采用的手术入路均为椎弓根入路。2篇文献NOS评分为8分,3篇文献为7分。Meta分析结果显示,治疗组骨水泥渗漏率低于对照组[OR=0.13,95%CI(0.05,0.35)]; 2组伤椎前缘高度、Oswestry功能障碍指数、手术时间及术后即刻、术后3 d和术后1个月疼痛视觉模拟量表评分比较,组间差异均无统计学意义[MD=-0.28,95%CI(-1.32,0.77); MD=0.61,95%CI(-0.93,2.16); MD=-2.42,95%CI(-7.65,2.81); MD=0.42,95%CI(-0.92,1.76); MD=-0.01,95%CI(-0.24,0.23); MD=0.07,95%CI(-0.05,0.18)]。3篇文献比较了2组OVCF患者治疗后的Cobb角,2篇文献比较了2组OVCF患者术中透视次数,但因比较Cobb角的时间节点不同以及记录术中透视次数的数据不统一,无法相互转化,故均未对其进行统计分析。结论:BFMCs椎体成形术和PKP治疗OVCF,均能恢复椎体高度、缓解疼痛、促进腰椎功能恢复,二者的手术时间相当,但BFMCs椎体成形术在降低骨水泥渗漏率方面优于PKP。
Abstract:
Objective:To compare the clinical curative effects and safety of bone filling mesh con-tainer(BFMCs)vertebroplasty versus percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fracture(OVCF).Methods:All the randomized controlled trial(RCT)articles and retrospective clinical trial articles about BFMCs vertebroplasty(treatment group)versus PKP(control group)for treatment of OVCF that published at home and abroad included from database establishing to May 15,2019 were retrieved from WanFang Database,China national knowledge internet,VIP Database,Chinese biomedical literature data-base and Pubmed Database through computer.The articles were screened and the information was extracted independently by two searchers according to the inclusion and exclusion criteria.The methodological quality of research in the articles was evaluated according to the Newcastle-Ottawa scale(NOS)and a Meta-analysis was conducted by using RevMan 5.3 software.Results:Fifty-one articles were searched out in the initial stage.After screening through reading titles and abstracts of the articles,30 repetitive articles were excluded,and after screening through reading the full texts of the remained articles in detail,5 Chinese articles were included in the final analysis.The curative effects were compared between BFMCs vertebroplasty,PKP and percutaneous vertebroplasty in 1 article,and were compared between BFMCs vertebroplasty and PKP in the other 4 articles.Three hundred and ninety-eight patients(443 injured vertebraes)were involved in the 5 articles,and all patients were treated through pedicle approaches.The NOS scores of 2 articles were 8 points and the NOS scores of 3 articles were 7 points.The results of Meta-analysis demonstrated that the incidence rate of bone cement leakage was lower in treatment group compared to control group(OR=0.13,95%CI(0.05,0.35)).There was no statistical difference in injured vertebrae anterior border height,Oswestry disability index(ODI),operative time and pain visual analogue scale(VAS)scores immediately after surgery and at 3 days and 1 month after the surgery between the 2 groups(MD=-0.28,95%CI(-1.32,0.77); MD=0.61,95%CI(-0.93,2.16); MD=-2.42,95%CI(-7.65,2.81); MD=0.42,95%CI(-0.92,1.76); MD=-0.01,95%CI(-0.24,0.23); MD=0.07,95%CI(-0.05,0.18)).The post-treatment Cobb angle of OVCF patients were compared between the 2 groups in 3 articles,and the frequency of intraoperative X-ray exposure for OVCF patients were compared between the 2 groups in 2 articles.The articles were inconsistent with each other in the timepoints for measuring Cobb angle and the data of frequency of intraoperative X-ray exposure,so they couldn't be merged for statistical analysis.Conclusion:Both BFMCs vertebroplasty and PKP can restore vertebral height,relieve pain and promote lumbar function recovery in treatment of OVCF,and they are similar to each other in operative time,while the former surpasses the latter in reducing incidence rate of bone cement leakage.

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备注/Memo

备注/Memo:
通讯作者:刘晋闽 E-mail:ljm19500501@126.com(收稿日期:2019-08-10 本文编辑:时红磊)
更新日期/Last Update: 2019-10-15