Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis
Background To evaluate outcomes following percutaneous vertebroplasty with high viscosity cement (PVP‐HVC) and percutaneous kyphoplasty (PKP) with normal‐viscosity cement in patients with osteoporotic vertebral compression fractures (OVCFs). Methods Pertinent studies were retrieved by searching five...
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| Veröffentlicht in: | ANZ journal of surgery 2022-11, Vol.92 (11), p.2849-2858 |
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| creator | Kou, Yu‐hui Zhang, Dian‐ying Zhang, Jin‐dong Han, Na Yang, Ming |
| description | Background
To evaluate outcomes following percutaneous vertebroplasty with high viscosity cement (PVP‐HVC) and percutaneous kyphoplasty (PKP) with normal‐viscosity cement in patients with osteoporotic vertebral compression fractures (OVCFs).
Methods
Pertinent studies were retrieved by searching five electronic databases up to July 2021. Additional records were identified via hand‐searching of related references. Risk ratio (RR) and weighted mean difference (WMD), with their 95% confidence intervals (CIs), were calculated. A trial sequential analysis (TSA) was done for cement leakage.
Results
Twelve studies, embracing 1050 patients with OVCFs, were included. PVP‐HVC was superior to PKP with normal‐viscosity cement regarding risk of cement leakage (RR: 0.67, 95% CI: 0.54–0.83, I2: 45.1%) and operation time (WMD: −11.26, 95% CI: −14.78 to −8.34, I2: 88.8%). However, TSA revealed that a sufficient level of evidence for leakage reduction may have yet to be reached. PKP groups had a significant decrease in Cobb's angles postoperatively (within 1 month, WMD: 2.68, 95% CI: 1.85–3.48, I2: 0%; after 1 year, WMD: 2.68, 95% CI: 1.35–4.01, I2: 0%). There are no significant differences between the two procedures pertaining to injected cement volume, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and risk of adjacent vertebral fractures.
Conclusion
PVP‐HVC and PKP with normal‐viscosity cement are safe and effective treatments for the management of OVCF, but the former is superior to the latter in terms of procedure time. The potential of PVP‐HVC in reducing cement leaks remains to be validated by more well‐designed studies.
1. This is the first meta‐analysis to directly compare vertebroplasty with high‐viscosity cement versus kyphoplasty with normal‐viscosity cement for osteoporotic vertebral compression fractures. 2. Overall results indicated a trend that vertebroplasty with high‐viscosity cement may help cement leakage reduction but trial sequential analysis revealed the need of additional studies for confirming this trend. |
| doi_str_mv | 10.1111/ans.17894 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2685039416</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2737313031</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3134-7d6cf3a0810f15f34aed1213513ad282a25a70f5ee1def5b3f080c706a34fd1b3</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhS0EomVgwQsgS2xgMa0d20mGXVXxU6miC362kce5ZlySOPg6U2XHG8Az8iTc6UxZVMKS5Xut7xxf6zD2XIoTSevUDngiq3qlH7BjqbVZFnJVPTzUUit1xJ4gXgshy3JlHrMjZara6FIds19fIWVYpzh2FvPMb0Le8E34tvnz8_c2oIsY6NZBD0PmW0g4IXdx2FIb4mA7_n0eN3diHxOPmCGOMcUc3E6wMyfMxX5MgEgi7pN1eaLuDbe8h2zpLUteMwZ8yh552yE8O5wL9uXd28_nH5aXV-8vzs8ul05JpZdVWzqvrKil8NJ4pS20spDKSGXboi5sYWwlvAGQLXizVl7UwlWitEr7Vq7Vgr3a-44p_pgAc9PTb6Hr7ABxwqYoayPUSsuS0Jf30Os4JZqXqEpVNI-gvWCv95RLETGBb8YUepvmRopml1JDKTW3KRH74uA4rXto_5F3sRBwugduQgfz_52as4-f9pZ_ATLvolA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2737313031</pqid></control><display><type>article</type><title>Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kou, Yu‐hui ; Zhang, Dian‐ying ; Zhang, Jin‐dong ; Han, Na ; Yang, Ming</creator><creatorcontrib>Kou, Yu‐hui ; Zhang, Dian‐ying ; Zhang, Jin‐dong ; Han, Na ; Yang, Ming</creatorcontrib><description>Background
To evaluate outcomes following percutaneous vertebroplasty with high viscosity cement (PVP‐HVC) and percutaneous kyphoplasty (PKP) with normal‐viscosity cement in patients with osteoporotic vertebral compression fractures (OVCFs).
Methods
Pertinent studies were retrieved by searching five electronic databases up to July 2021. Additional records were identified via hand‐searching of related references. Risk ratio (RR) and weighted mean difference (WMD), with their 95% confidence intervals (CIs), were calculated. A trial sequential analysis (TSA) was done for cement leakage.
Results
Twelve studies, embracing 1050 patients with OVCFs, were included. PVP‐HVC was superior to PKP with normal‐viscosity cement regarding risk of cement leakage (RR: 0.67, 95% CI: 0.54–0.83, I2: 45.1%) and operation time (WMD: −11.26, 95% CI: −14.78 to −8.34, I2: 88.8%). However, TSA revealed that a sufficient level of evidence for leakage reduction may have yet to be reached. PKP groups had a significant decrease in Cobb's angles postoperatively (within 1 month, WMD: 2.68, 95% CI: 1.85–3.48, I2: 0%; after 1 year, WMD: 2.68, 95% CI: 1.35–4.01, I2: 0%). There are no significant differences between the two procedures pertaining to injected cement volume, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and risk of adjacent vertebral fractures.
Conclusion
PVP‐HVC and PKP with normal‐viscosity cement are safe and effective treatments for the management of OVCF, but the former is superior to the latter in terms of procedure time. The potential of PVP‐HVC in reducing cement leaks remains to be validated by more well‐designed studies.
1. This is the first meta‐analysis to directly compare vertebroplasty with high‐viscosity cement versus kyphoplasty with normal‐viscosity cement for osteoporotic vertebral compression fractures. 2. Overall results indicated a trend that vertebroplasty with high‐viscosity cement may help cement leakage reduction but trial sequential analysis revealed the need of additional studies for confirming this trend.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.17894</identifier><identifier>PMID: 35785463</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Bone Cements - therapeutic use ; Bone surgery ; Cement ; Compression ; compression fractures ; Fractures ; Fractures, Compression - surgery ; Humans ; kyphoplasty ; Kyphoplasty - methods ; Leakage ; Meta-analysis ; Osteoporosis ; Retrospective Studies ; Risk ; Searching ; Sequential analysis ; Spinal Fractures - surgery ; Treatment Outcome ; Vertebrae ; Vertebroplasty ; Viscosity</subject><ispartof>ANZ journal of surgery, 2022-11, Vol.92 (11), p.2849-2858</ispartof><rights>2022 Royal Australasian College of Surgeons.</rights><rights>2022 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3134-7d6cf3a0810f15f34aed1213513ad282a25a70f5ee1def5b3f080c706a34fd1b3</cites><orcidid>0000-0001-5002-9256</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.17894$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.17894$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35785463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kou, Yu‐hui</creatorcontrib><creatorcontrib>Zhang, Dian‐ying</creatorcontrib><creatorcontrib>Zhang, Jin‐dong</creatorcontrib><creatorcontrib>Han, Na</creatorcontrib><creatorcontrib>Yang, Ming</creatorcontrib><title>Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
To evaluate outcomes following percutaneous vertebroplasty with high viscosity cement (PVP‐HVC) and percutaneous kyphoplasty (PKP) with normal‐viscosity cement in patients with osteoporotic vertebral compression fractures (OVCFs).
Methods
Pertinent studies were retrieved by searching five electronic databases up to July 2021. Additional records were identified via hand‐searching of related references. Risk ratio (RR) and weighted mean difference (WMD), with their 95% confidence intervals (CIs), were calculated. A trial sequential analysis (TSA) was done for cement leakage.
Results
Twelve studies, embracing 1050 patients with OVCFs, were included. PVP‐HVC was superior to PKP with normal‐viscosity cement regarding risk of cement leakage (RR: 0.67, 95% CI: 0.54–0.83, I2: 45.1%) and operation time (WMD: −11.26, 95% CI: −14.78 to −8.34, I2: 88.8%). However, TSA revealed that a sufficient level of evidence for leakage reduction may have yet to be reached. PKP groups had a significant decrease in Cobb's angles postoperatively (within 1 month, WMD: 2.68, 95% CI: 1.85–3.48, I2: 0%; after 1 year, WMD: 2.68, 95% CI: 1.35–4.01, I2: 0%). There are no significant differences between the two procedures pertaining to injected cement volume, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and risk of adjacent vertebral fractures.
Conclusion
PVP‐HVC and PKP with normal‐viscosity cement are safe and effective treatments for the management of OVCF, but the former is superior to the latter in terms of procedure time. The potential of PVP‐HVC in reducing cement leaks remains to be validated by more well‐designed studies.
1. This is the first meta‐analysis to directly compare vertebroplasty with high‐viscosity cement versus kyphoplasty with normal‐viscosity cement for osteoporotic vertebral compression fractures. 2. Overall results indicated a trend that vertebroplasty with high‐viscosity cement may help cement leakage reduction but trial sequential analysis revealed the need of additional studies for confirming this trend.</description><subject>Bone Cements - therapeutic use</subject><subject>Bone surgery</subject><subject>Cement</subject><subject>Compression</subject><subject>compression fractures</subject><subject>Fractures</subject><subject>Fractures, Compression - surgery</subject><subject>Humans</subject><subject>kyphoplasty</subject><subject>Kyphoplasty - methods</subject><subject>Leakage</subject><subject>Meta-analysis</subject><subject>Osteoporosis</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Searching</subject><subject>Sequential analysis</subject><subject>Spinal Fractures - surgery</subject><subject>Treatment Outcome</subject><subject>Vertebrae</subject><subject>Vertebroplasty</subject><subject>Viscosity</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EomVgwQsgS2xgMa0d20mGXVXxU6miC362kce5ZlySOPg6U2XHG8Az8iTc6UxZVMKS5Xut7xxf6zD2XIoTSevUDngiq3qlH7BjqbVZFnJVPTzUUit1xJ4gXgshy3JlHrMjZara6FIds19fIWVYpzh2FvPMb0Le8E34tvnz8_c2oIsY6NZBD0PmW0g4IXdx2FIb4mA7_n0eN3diHxOPmCGOMcUc3E6wMyfMxX5MgEgi7pN1eaLuDbe8h2zpLUteMwZ8yh552yE8O5wL9uXd28_nH5aXV-8vzs8ul05JpZdVWzqvrKil8NJ4pS20spDKSGXboi5sYWwlvAGQLXizVl7UwlWitEr7Vq7Vgr3a-44p_pgAc9PTb6Hr7ABxwqYoayPUSsuS0Jf30Os4JZqXqEpVNI-gvWCv95RLETGBb8YUepvmRopml1JDKTW3KRH74uA4rXto_5F3sRBwugduQgfz_52as4-f9pZ_ATLvolA</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Kou, Yu‐hui</creator><creator>Zhang, Dian‐ying</creator><creator>Zhang, Jin‐dong</creator><creator>Han, Na</creator><creator>Yang, Ming</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5002-9256</orcidid></search><sort><creationdate>202211</creationdate><title>Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis</title><author>Kou, Yu‐hui ; Zhang, Dian‐ying ; Zhang, Jin‐dong ; Han, Na ; Yang, Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3134-7d6cf3a0810f15f34aed1213513ad282a25a70f5ee1def5b3f080c706a34fd1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bone Cements - therapeutic use</topic><topic>Bone surgery</topic><topic>Cement</topic><topic>Compression</topic><topic>compression fractures</topic><topic>Fractures</topic><topic>Fractures, Compression - surgery</topic><topic>Humans</topic><topic>kyphoplasty</topic><topic>Kyphoplasty - methods</topic><topic>Leakage</topic><topic>Meta-analysis</topic><topic>Osteoporosis</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Searching</topic><topic>Sequential analysis</topic><topic>Spinal Fractures - surgery</topic><topic>Treatment Outcome</topic><topic>Vertebrae</topic><topic>Vertebroplasty</topic><topic>Viscosity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kou, Yu‐hui</creatorcontrib><creatorcontrib>Zhang, Dian‐ying</creatorcontrib><creatorcontrib>Zhang, Jin‐dong</creatorcontrib><creatorcontrib>Han, Na</creatorcontrib><creatorcontrib>Yang, Ming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kou, Yu‐hui</au><au>Zhang, Dian‐ying</au><au>Zhang, Jin‐dong</au><au>Han, Na</au><au>Yang, Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2022-11</date><risdate>2022</risdate><volume>92</volume><issue>11</issue><spage>2849</spage><epage>2858</epage><pages>2849-2858</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
To evaluate outcomes following percutaneous vertebroplasty with high viscosity cement (PVP‐HVC) and percutaneous kyphoplasty (PKP) with normal‐viscosity cement in patients with osteoporotic vertebral compression fractures (OVCFs).
Methods
Pertinent studies were retrieved by searching five electronic databases up to July 2021. Additional records were identified via hand‐searching of related references. Risk ratio (RR) and weighted mean difference (WMD), with their 95% confidence intervals (CIs), were calculated. A trial sequential analysis (TSA) was done for cement leakage.
Results
Twelve studies, embracing 1050 patients with OVCFs, were included. PVP‐HVC was superior to PKP with normal‐viscosity cement regarding risk of cement leakage (RR: 0.67, 95% CI: 0.54–0.83, I2: 45.1%) and operation time (WMD: −11.26, 95% CI: −14.78 to −8.34, I2: 88.8%). However, TSA revealed that a sufficient level of evidence for leakage reduction may have yet to be reached. PKP groups had a significant decrease in Cobb's angles postoperatively (within 1 month, WMD: 2.68, 95% CI: 1.85–3.48, I2: 0%; after 1 year, WMD: 2.68, 95% CI: 1.35–4.01, I2: 0%). There are no significant differences between the two procedures pertaining to injected cement volume, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and risk of adjacent vertebral fractures.
Conclusion
PVP‐HVC and PKP with normal‐viscosity cement are safe and effective treatments for the management of OVCF, but the former is superior to the latter in terms of procedure time. The potential of PVP‐HVC in reducing cement leaks remains to be validated by more well‐designed studies.
1. This is the first meta‐analysis to directly compare vertebroplasty with high‐viscosity cement versus kyphoplasty with normal‐viscosity cement for osteoporotic vertebral compression fractures. 2. Overall results indicated a trend that vertebroplasty with high‐viscosity cement may help cement leakage reduction but trial sequential analysis revealed the need of additional studies for confirming this trend.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>35785463</pmid><doi>10.1111/ans.17894</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5002-9256</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Bone Cements - therapeutic use Bone surgery Cement Compression compression fractures Fractures Fractures, Compression - surgery Humans kyphoplasty Kyphoplasty - methods Leakage Meta-analysis Osteoporosis Retrospective Studies Risk Searching Sequential analysis Spinal Fractures - surgery Treatment Outcome Vertebrae Vertebroplasty Viscosity |
| title | Vertebroplasty with high‐viscosity cement versus conventional kyphoplasty for osteoporotic vertebral compression fractures: a meta‐analysis |
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