Meta Analysis Of Unilateral Versus Bilateral Balloon Kyphoplasty For The Treatment Of Osteoporotic Vertebral Compression Fractures

Objective:To compare unilateral and bilateral balloon kyphoplasty(BKP) for the treatment of osteoporotic vertebral compression fractures by meta-analysis. Methods:The literature related to application of unilateral or bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures were searched from Pubmed, Springer and Wan Fang data basis. Related Chinese journals were hand-searched. RevMan5.0provided by Cochrane was used to analyze the data. Results:2RCTs,8retrospective clinical controlled trails were included. Meta-analysis results showed that there are no significant differences (P>0.05) in the postoperative kyphotic angle[MD=0.30,95%CI(-2.17,2.77),P=0.81],the anterior vertebral height at final follow-up[MD=-0.90,95%CI(-2.08,0.28),P=0.13],and the incidence of the cement leakage[MD=1.02,95%CI(0.58,1.81),P=0.94]. Compared with bilateral BKP, unilateral BKP is of less operative time[MD=-22.68,95%CI(-33.35,-12.02),P<0.0001], and less bone cement volume[MD=-2.17,95%CI(-3.18,-1.16),P<0.0001]. Compared with unilateral BKP, Bilateral BKP can significantly relieve the post-operative pain[MD=0.32,95%CI(0.02,0.62),P=0.04].Conclusion:Unilateral BKP has similar clinic result compared with bilateral BKP for osteoporotic thoracolumbar compression fractures. Compared with bilateral BKP, unilateral BKP is of less operative time, and less bone cement volume. Bilateral BKP appears superior to unilateral BKP in the post-operative pain.