骨填充网袋成形术与PKP治疗Kümmell病有效性和安全性的Meta分析  

Effectiveness and safety of bone-filling mesh containers vertebroplasty versus percutaneous kyphoplasty for treating Kümmell disease:a Meta-analysis

作　　者：秦聪聪[1] 张亚宁[1] 王宇飞[1] 苏江平[1] 刘博 QIN Cong-cong;ZHANG Ya-ning;WANG Yu-fei;SU Jiang-ping;LIU Bo(Department of Spine Surgery,Linfen People′s Hospital,Linfen,Shanxi 041000,China)

机构地区：[1]临汾市人民医院脊柱外科,山西临汾041000

出　　处：《颈腰痛杂志》2024年第6期1092-1098,共7页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的系统评价骨填充网袋椎体成形术(BFC)与经皮椎体后凸成形术(PKP)治疗Kümmell病的有效性与安全性。方法通过计算机检索收录于外文Cochrane library、PubMed、Embase数据库,中文CNKI、维普、万方数据库和中国生物医学文献数据库,搜集截至2021年6月之前所有比较BFC和PKP治疗Kümmell病的临床对照研究,筛选后提取数据,采用RevMan 5.3分析软件,评价两种术式的手术时间、骨水泥注入量、术后短期及长期随访的VAS及ODI评分、术后Cobb角、骨水泥渗漏及邻近节段椎体再骨折发生率。结果本研究共纳入2篇随机对照试验(RCT)和4篇回顾性病例对照研究(CCT),共计6项研究286例患者,其中BFC组130例,PKP组156例。Meta分析结果显示:两组患者手术时间[MD=0.09,95%CI(-6.87,7.05),P=0.98]、骨水泥注入量[MD=0.21,95%CI(-1.15,1.56),P=0.77]、术后短期和长期随访VAS评分[MD短期=0.05,95%CI(-0.13,0.22),P=0.59;MD长期=0.06,95%CI(-0.88,0.19),P=0.41]、ODI评分[MD短期=0.21,95%CI(-0.84,1.25),P=0.70;MD长期=-0.49,95%CI(-1.13,0.16),P=0.14]、Cobb角[MD短期=0.08,95%CI(-0.56,0.71),P=0.82;MD长期=0.19,95%CI(-0.69,1.07),P=0.14]及邻近节段椎体骨折发生率[OR=0.60,95%CI(0.20,1.85),P=0.38]差异无统计学意义。BFC组术后骨水泥渗漏发生率更低[OR=0.17,95%CI(0.07,0.37),P<0.01]。结论与PKP相比,BFC在改善Kümmell病患者术后VAS、ODI评分及Cobb角具有相似的临床疗效,但BFC安全性更高。Objective To systematically evaluate the effectiveness and safety of bone-filling mesh containers(BFC)versus percutaneous kyphoplasty(PKP)in the treatment of Kümmell disease.Methods A computer-based search was performed via Cochrane library,PubMed,Embase,CNKI,VIP,CBM and Wanfang databases.All controlled clinical trials comparing BFC and PKP for Kümmell disease up to June 2021 were collected and the relevant data were extracted after screening.RevMan 5.3 analysis software was used to evaluate the operation time,injected cement volume,VAS and ODI scores,cobb angle at short-term and long-term postoperative follow-up,incidence of bone cement leakage and adjacent-level fracture between the two groups.Results Two randomised controlled trials(RCTs)and 4 retrospective case-control studies(CCTs)were included,with a total of 286 patients in 6 studies,including 130 in the BFC group and 156 in the PKP group.Meta-analysis showed that no statistical significance had been fond upon the operation time[MD=0.09,95%CI(-6.87,7.05),P=0.98],injected cement volume[MD=0.21,95%CI(-1.15,1.56),P=0.77],VAS scores[MD short-term=0.05,95%CI(-0.13,0.22),P=0.59;MD long-term=0.06,95%CI(-0.88,0.19),P=0.41],ODI score[MD short-term=0.21,95%CI(-0.84,1.25),P=0.70;MD long-term=-0.49,95%CI(-1.13,0.16),P=0.14]and Cobb angle[MD short-term=0.08,95%CI(-0.56,0.71),P=0.82;MD long-term=0.19,95%CI(-0.69,1.07),P=0.14]at short and long-term postoperative follow-up,as well as the adjacent-level fracture rate[OR=0.60,95%CI(0.20,1.85),P=0.38]between the two groups.Whilst the BFC group had a lower incidence of postoperative bone cement leakage[OR=0.14,95%CI(0.09,0.23),P<0.01].Conclusion Compared to PKP,BFC has similar clinical efficacy in improving postoperative VAS,ODI scores and Cobb angle in patients with Kümmell disease,but BFC has a higher safety profile.

关 键 词：椎体成形术 椎体裂隙征 压缩性骨折 Kümmell病 META分析 

分 类 号：R683.2[医药卫生—骨科学]