椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的系统评价  

Vertebroplasty versus non-operative therapy for the treatment of osteoporotic vertebral compressive fractures:a systematic review

作　　者：曹立颖[1] 王建民[1] 杨声坪[1] 姜明静[2] 

机构地区：[1]兰州大学第一医院骨科,兰州730000 [2]兰州大学第一医院神经内科,兰州730000

出　　处：《中国骨质疏松杂志》2012年第6期516-522,共7页Chinese Journal of Osteoporosis

摘　　要：目的系统评价椎体成形术和非手术治疗骨质疏松椎体压缩性骨折的治疗效果。方法应用Cochrane系统评价方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库和维普数据库,并手工检索相关领域杂志。检索不受语种限制,时间均从建库至2011年11月。收集以椎体成形术和非手术治疗骨质疏松性椎体压缩骨折的所有随机对照试验(RCTs)。进行资料提取和质量评价,用RevMan 5.0软件进行统计学分析。结果最终纳入7个RCTs,共614例患者。研究结果显示:与保守治疗相比,随访1、4、12、24、48w时椎体成形术在缓解疼痛方面更明显;在新发骨折发生方面,两种治疗方法无统计学意义。与安慰剂相比,随访4w时椎体成形术在缓解疼痛、提高腰部功能活动及改善生活质量方面并无明显优势。结论与保守治疗相比,椎体成形术在缓解疼痛方面具有一定的优势,但是远期疗效还需更大量的高质量文献提供科学的证据。由于纳入研究质量和病例数量的局限,上述结论尚需要更多高质量的随机对照试验进一步验证。Objective To systematically assess the efficacy of vertebroplasty and non-operative therapy for the treatment of osteoporotic vertebral compressive fractures. Methods Cochrane Library, PubMed, EMBASE, Chinese Bio-medicine Database, China Journal Full-text Database, VIP database were searched based on the principles and methods of Cochrane systematic review method. Related magazines were searched manually. The search started from the data establishment to November 2011 without language limitation. Randomized controlled trials （RCTs） of vertebroplasty versus non-operative therapy for the treatment of osteoporotic vertebral compression fractures were included. Data were extracted and their quality was evaluated. The Cochrane Collaboration＇ s software RevMan 5.0 was used for meta-analysis. Results Seven RCTs, including 614 patients, were included. Results showed that the pain relief of patients treated with vertebroplasty was more obvious than that with the conservative treatment in 1, 4, 12, 24, and 48 weeks follow-up. However, there was no significant difference in incidence of new fractures between patient＇s in the two groups. In addition, there was no significant advantage of the vertebroplasty than the placebo in pain relief, the improvement of functional activities of waist, and quality of life in 4 weeks follow- up. Conclusion Comparing with conservative treatment, vertebroplasty in pain relief has certain advantages. But it needs more high-quality research to assess the long-term effect of different treatments. The above conclusions still need more high-quality randomized controlled trails to verify because of the limitation of the number and quality of the included studies.

关 键 词：椎体成形术 骨质疏松 椎体压缩骨折 系统评价 META分析 

分 类 号：R683.2[医药卫生—骨科学]