The Comparison Of Clinical Efficacy For Osteoporotic Vertebral Compression Fractures

Background:The osteoporosis is a common disease in middle-aged and old people,osteoporotic vertebral compression fracture is also one of the most common clinical fractures.The commonly used therapeutic schedule includes conservative treatment and surgical treatment.Conservative treatment mainly includes bed rest,oral or parenteral analgesics and antiosteoporosis drugs,external back bracing et al.Surgical treatment includes percutaneous vertebroplasty and percutaneous kyphoplasty.In recent years,there is some controversy over clinical curative effect and complications of conservative treatment and percutaneous vertebroplasty with percutaneous kyphoplasty for osteoporotic vertebral compression fractures,it deserves further research and discussion.Method:Pub Med、EMBASE、MEDLINE、Web of Science、Springer Link and other english databases were searched for all the relevant original articles comparing percutaneous vertebroplasty with conservative treatment for osteoporotic vertebral compression fractures and articles comparing percutaneous vertebroplasty with percutaneous kyphoplasty for osteoporotic vertebral compression fractures.According to the inclusion and exclusion criterias,two reviewers screened the articles and assessed the quality,then conducted a meta-analysis with the datas including basic information,clinical outcomes,radiological datas,complications(secondary fractures,cement leakage).Results:Part I : A meta-analysis of comparing clinical outcomes following percutaneous vertebroplasty with conservative therapy for osteoporotic vertebral compression fracturesThe VAS scores of PVP treatment group after surgery,1 day,1 to 2 weeks,1 month,3 months,6 months,1 year were lower than conservative treatment group;The ODI scores of PVP treatment group in postoperative 1 week,1 month,6 months,1 year were significantly lower than conservative treatment group;PVP treatment group withconservative treatment group the last follow-up found no difference between the incidence of vertebral fractures in again.Part II : A meta-analysis of comparing clinical outcomes following percutaneous vertebroplasty with percutaneous kyphoplasty for osteoporotic vertebral compression fracturesPVP treatment group with conservative treatment group after surgery,1 week,3-6months,1 year found no difference between the VAS scores;PVP treatment group with conservative treatment group after surgery,3 months,1 year found no difference between the ODI scores;The Cobb angle of PKP treatment group at the end of the preoperative and postoperative follow-up was significantly lower than conservative treatment group;The front and middle vertebral body compression ratio of PKP treatment group at the end of the preoperative and postoperative follow-up was significantly lower than conservative treatment group;The bone cement leakage rate of PKP treatment group at the end of the preoperative and postoperative follow-up was significantly lower than conservative treatment group;The bone cement usage of PKP treatment group was greater than the PVP treatment group;PVP treatment group with PKP treatment group the last follow-up found no difference between the incidence of vertebral fractures in again.Conclusions:1、PVP treatment is significantly better than conservative treatment for osteoporotoc vertebral compression fractures,it can quickly relieve pain and improve the dysfunction,reducing the occurrence of a series of complications due to conservative treatment.It can improve the survival rate of patients and has better sercuity.2、PKP treatment has a better therapeutic effect on restoring vertebral body height and correcting spine protrusion deformity,reducing the complications such as leakage of bone cement.3、Regardless of conservative treament,PVP and PKP,each has a unique advantage.Medicial workers should strickly choose and make therapeutic plan according to the actual situation of patient,relieving pain and improving fuction obstacle,reducing compliactions.