椎体内裂隙征对骨质疏松性椎体压缩骨折椎体成形术后骨水泥渗漏发生率影响的Meta分析  

A meta-analysis of influence of intravertebral cleft on incidence of bone cement leakage following vertebroplasty for osteoporotic vertebral compression fractures

作　　者：杨夏 唐华羽[1] YANG Xia;TANG Huayu(Department of Spinal Surgery,the First Affiliated Hospital of Jiamusi University,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]佳木斯大学附属第一医院脊柱外科,黑龙江佳木斯154002

出　　处：《中国骨与关节损伤杂志》2025年第3期243-247,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的通过Meta分析椎体内裂隙征对骨质疏松性椎体压缩骨折椎体成形术后的骨水泥渗漏发生率的影响。方法检索PubMed、Embase、Web of Science数据库中有关椎体成形术治疗骨质疏松性椎体压缩骨折的文献,经过筛选和质量评估,将确定的文献分为椎体内裂隙征组和非椎体内裂隙征组,并将数据导入Stata 14.0软件进行Meta分析。基于数据的异质性采用随机效应模型或固定效应模型生成森林图,进行敏感性分析以评估结果的稳定性。结果Meta分析纳入21篇文献,质量评估结果显示8项研究为9分,11项研究为8分,2项研究为7分。Meta分析结果显示,无论骨质疏松性椎体压缩骨折患者是否合并椎体内裂隙征,椎体成形术后整体骨水泥渗漏发生率、椎旁骨水泥渗漏发生率差异无统计学意义(P>0.05)。椎体内裂隙征组B型和S型骨水泥渗漏发生率较非椎体内裂隙征组低,而C型和D型骨水泥渗漏发生率较非椎体内裂隙征组高(P<0.05)。敏感性分析结果显示,组间B型和D型骨水泥渗漏发生率不稳定,而组间C型和S型骨水泥渗漏发生率表现出一致性和可靠性。结论相较于未合并椎体内裂隙征骨质疏松性椎体压缩骨折患者,合并椎体内裂隙征骨质疏松性椎体压缩骨折患者椎体成形术后可能更容易发生C型及D型骨水泥渗漏,而非B型及S型骨水泥渗漏,不能仅仅将整体骨水泥渗漏发生率作为评估治疗有效性的指标。Objective To investigate the impact of intravertebral cleft on the incidence of bone cement leakage after vertebroplasty for osteoporotic vertebral compression fractures(OVCFs)through a Meta-analysis.Methods Relevant studies on vertebroplasty for treating OVCFs were retrieved from PubMed,Embase,and Web of Science databases.After screening and quality assessment,the included studies were divided into the intravertebral cleft group and the non-intravertebral cleft group.Data were imported into Stata 14.0 software for Meta-analysis.Forest plots were generated using random-effects or fixed-effects models based on data heterogeneity,and sensitivity analysis was conducted to evaluate the stability of the results.Results A total of 21 studies were included in the Meta-analysis.The quality assessment showed that eight studies scored 9 points,eleven studies scored 8 points,and two studies scored 7 points.The Meta-analysis results indicated that there was no significant difference in the overall incidence of bone cement leakage or paravertebral leakage between OVCFs patients with or without intravertebral cleft(P>0.05).However,in the intravertebral cleft group,the incidence of type B and type S bone cement leakage was lower,while the incidence of type C and type D leakage was higher compared to the non-intravertebral cleft group(P<0.05).Sensitivity analysis revealed that the incidence of type B and type D leakage between groups was unstable,whereas the incidence of type C and type S leakage showed consistency and reliability.Conclusion Compared with OVCFs patients without intravertebral cleft,those with intravertebral cleft may be more prone to type C and type D bone cement leakage after vertebroplasty,but not type B or type S leakage.The overall incidence of bone cement leakage should not be used solely as an indicator of treatment effectiveness.

关 键 词：椎体内裂隙征 骨质疏松性椎体压缩骨折 经皮椎体成形术 骨水泥渗漏 

分 类 号：R687.3[医药卫生—骨科学]