| Objective:To evaluate the effectiveness of vertebroplasty versus nonoperative in treatment of vertebral compression fractures. Methods:Randomized controlled trials (RCTs) related to vertebroplasty in treatment of vertebral compression fractures were identified from The Cochrane Library (the first issue of 2011),PubMed (1966 to Jan. 2011), EMBASE (1974 to Jan.2011), CBM (1978 to Jan.2011), CNKI (1994 to Jan. 2011), and WANFANG Databases (1997 to Jan.2011). The quality of included studies was evaluated according to the criteria provided by Cochrane Collaboration. Meta-analyses were performed by RevMan 5.0.17 software. Results:4 RCTs involving 445 patients were included. The results of meta-analyses indicated that there were significant differences between the vertebroplasty and conservative treatment follow-up 1th week and1th,6th and 12th month in VAS scores [WMD=-2.10,95%CI(-2.81,-1.39)], [WMD=-2.40,95%CI (-3.13,-1.67)], [WMD=-1.60,95%CI(-2.37,-0.83)], [WMD=-1.60, 95%CI(-2.45,-0.75)], While the rates of new adjacent vertebral compression fractures [OR=0.71,95%CI (0.35,1.43)]. There were no significant differences between the vertebroplasty and placebo follow-up 1th month in VAS scores [WMD=-0.13,95%CI (-1.39,1.13)], RDQ scores [WMD=-0.22,95%CI(-2.01,1.57)], EQ-5D scores [WMD=-0.05,95%CI (-0.01,0.11)], and there were no significant differences between the vertebroplasty and placebo the rates of new adjacent vertebral compression fractures [OR=0.75,95%CI (0.16,3.62)], the rates of adverse events [OR=1.28,95%CI (0.53, 3.11)]. Conclusion:The evidence indicates that compared with conservative treatment group, vertebroplasty could significantly relief pain throughout follow-up, however, compared with the placebo group, there is no advantage for the vertebroplasty group over the placebo group in back-pain relief, functional disability, and quality of life. More RCTs are required to verify these conclusions owing to the limitations of the present study. |
