经皮椎体后凸成形术和经皮椎体成形术治疗Kummell病临床疗效的Meta分析  

Efficacy of Percutaneous Kyphoplasty Versus Percutaneous Vertebroplasty for Kummell′s Disease:A Systematic Review and Meta-Analysis

作　　者：郑鑫泽 林晓晓 廖文庆 张瀚麟 赵泽铤 李干[2] 王东平 ZHENG Xinze;LIN Xiaoxiao;LIAO Wenqing(Guangzhou University of Chinese Medicine,Guangdong 510405,China)

机构地区：[1]广州中医药大学,510405 [2]南方医科大学珠江医院骨科,广州510260

出　　处：《医学研究杂志》2024年第1期63-69,146,共8页Journal of Medical Research

基　　金：广东省自然科学基金资助项目(2018A030313619)。

摘　　要：目的评估经皮椎体成形术和经皮椎体后凸成形术在治疗Kummell病的临床疗效和安全性。方法检索建库至2022年6月1日的Cochrane Library、PubMed、Medline、Embase、Web of Science、中国知网、维普网、万方数据知识服务平台和中国生物医学文献等数据库中关于经皮椎体后凸成形术和经皮椎体成形术治疗Kummell病的临床研究,并根据指定的纳入和排除标准进行文献筛选。在严格遵守Cochrane系统评价原则的条件下,对文献质量进行合理分析评估以及再筛选,后使用Review manager 5.4软件对各研究中的术后ODI、VAS评分、手术时间、术中出血量、术后椎体前缘高度、术后Cobb′s角和骨水泥渗漏等评价指标进行统计分析。结果筛选后共纳入符合筛选标准的文献9篇,其中英文文献4篇,中文文献5篇,共收录经皮椎体成形术组243例,经皮椎体后凸成形术组222例,共计465例患者。经皮椎体后凸成形术与经皮椎体成形术比较,术后ODI评分、骨水泥渗漏和术后Cobb′s角等方面存在优势,差异有统计学意义(P<0.05),但手术时间较长,术后VAS评分改善效果较差。术中出血量和术后椎体前缘高度差异无统计学意义(P>0.05)。结论在Kummell病的手术治疗中,与传统的经皮椎体成形术比较,经皮椎体后凸成形术在改善术后ODI评分、减少骨水泥渗漏风险、缩小术后Cobb′s角方面具有更好的效果,在提高临床疗效与降低术后风险上更具优势。Objective To evaluate the clinical efficacy and safety of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of Kummell′disease.Methods Databases of Cochrane Library,PubMed,Medline,Embase,Web of Science,CNKI,VIP,Wanfang Data and CBM were used to search clinical studies on percutaneous kyphoplasty virus percutaneous vertebroplasty in the treatment of Kummell′s disease from database inception until June 1st,2022.Literature screening was performed according to the specified inclusion and exclusion criteria.In strict compliance with Cochrane′s systematic evaluation principle,authors reasonably screened,evaluated and analyzed the quality of the retrieved papers and then the evaluating indicator of postoperative ODI,JOA,VAS,operation time and intraoperative complications in each included study was evaluated in Review Manager 5.4software.Results Nine papers were included,involving 243 patients in the percutaneous vertebroplasty group and 222 patients in the percutaneous kyphoplasty group.Percutaneous kyphoplasty had advantages in postoperative ODI score,cement leakage,and postoperative Cobb′s angle,which was statistically significant(P<0.05),but the operation time was longer and the postoperative VAS score improved poorly.There was no significant difference in intraoperative bleeding and height of the postoperative vertebral margin(P>0.05).Conclusion In the surgical treatment of Kummell′s disease,percutaneous vertebral kyphoplasty can more effectively improve the postoperative ODI score,and reduce the postoperative Cobb′s angle and the risk of cement leakage compared to the traditional percutaneous vertebroplasty.It has more advantages in improving the clinical efficacy and reducing the postoperative risk.However,the conclusions of this study require more high-quality,multi-angle and large-sample studies in the future.

关 键 词：Kummell病 经皮椎体成形术 经皮椎体后凸成形术 META分析 

分 类 号：R681[医药卫生—骨科学]