Abstract：
OBJECTIVE: To compare the efficacy and safety of vertebroplasty through different pedicle approaches in the treatment of osteoporotic vertebral compression fracture osteoporotic vertebral compression fractures (OVCF) by network meta-analysis.
METHODS: Pubmed, Embase, Cochrane Library, Web of Science. Database for literature retrieval, retrieval time from the establishment of the database to April 2023, the randomized controlled trials of unilateral vertebroplasty (UVP), bilateral vertebroplasty (BVP), unilateral kyphoplasty (UKP), bilateral kyphoplasty (BKP), curved vertebroplasty (CVP) and curved kyphoplasty (CKP) were screened, evaluated and the data were extracted and included in the analysis. STATA 15.0 and ReMan 5.3 were used for data analysis. This study was registered in the National Institute for Health Research (NIHR) with the registration number CRD42023405181.
RESULTS: This study included 16 articles with a total of 1712 patients. The order of visual analogue scale (VAS) improvement from good to bad is CVP > BVP > UVP > CKP > BKP > UKP. The order of kyphotic angles improvement from good to bad is CKP > UKP > UKP > UVP > BVP > CVP. The order of bone cement injection from less to more is UVP > CVP > UKP > CKP > BVP > BKP. The order of bone cement leakage rate from less to more is CKP > CVP > UKP > BKP > UVP > BVP. The order of X-ray exposure time from less to more is CKP > CVP > UVP > BVP > UKP > BKP. The order of operation time from less to more is CVP > UVP > UKP > CKP > BVP > BKP.
CONCLUSIONS: For patients with kyphotic angles, kyphoplasty has unique advantages in improving kyphotic angles. But generally speaking, curved approach can optimize the distribution of bone cement through unilateral approach to achieve the orthopedic effect of bilateral approach, which is a minimally invasive technique with better curative effect and higher safety in the treatment of OVCF.
METHODS: Pubmed, Embase, Cochrane Library, Web of Science. Database for literature retrieval, retrieval time from the establishment of the database to April 2023, the randomized controlled trials of unilateral vertebroplasty (UVP), bilateral vertebroplasty (BVP), unilateral kyphoplasty (UKP), bilateral kyphoplasty (BKP), curved vertebroplasty (CVP) and curved kyphoplasty (CKP) were screened, evaluated and the data were extracted and included in the analysis. STATA 15.0 and ReMan 5.3 were used for data analysis. This study was registered in the National Institute for Health Research (NIHR) with the registration number CRD42023405181.
RESULTS: This study included 16 articles with a total of 1712 patients. The order of visual analogue scale (VAS) improvement from good to bad is CVP > BVP > UVP > CKP > BKP > UKP. The order of kyphotic angles improvement from good to bad is CKP > UKP > UKP > UVP > BVP > CVP. The order of bone cement injection from less to more is UVP > CVP > UKP > CKP > BVP > BKP. The order of bone cement leakage rate from less to more is CKP > CVP > UKP > BKP > UVP > BVP. The order of X-ray exposure time from less to more is CKP > CVP > UVP > BVP > UKP > BKP. The order of operation time from less to more is CVP > UVP > UKP > CKP > BVP > BKP.
CONCLUSIONS: For patients with kyphotic angles, kyphoplasty has unique advantages in improving kyphotic angles. But generally speaking, curved approach can optimize the distribution of bone cement through unilateral approach to achieve the orthopedic effect of bilateral approach, which is a minimally invasive technique with better curative effect and higher safety in the treatment of OVCF.
摘要：
目的：通过网络Meta分析比较不同椎弓根椎体成形术治疗骨质疏松性椎体压缩骨折(OVCF)的疗效和安全性。
方法：发布，Embase,科克伦图书馆,Web的科学。文献检索数据库，检索时间从数据库建立到2023年4月,单侧椎体成形术(UVP)的随机对照试验,双侧椎体成形术(BVP),单侧椎体后凸成形术（UKP），双侧椎体后凸成形术(BKP),筛选弯曲椎体成形术（CVP）和弯曲椎体后凸成形术（CKP），评估并提取数据并纳入分析。使用STATA15.0和ReMan5.3进行数据分析。这项研究在美国国立卫生研究院（NIHR）注册，注册号为CRD42023405181。
结果：本研究共纳入16篇文献，共1712例患者。视觉模拟量表（VAS）改善从好到坏的顺序是CVP>BVP>UVP>CKP>BKP>UKP。后凸角改善从好到坏的顺序是CKP>UKP>UKP>UVP>BVP>CVP。骨水泥注入从少到多的顺序是UVP>CVP>UKP>CKP>BVP>BKP。骨水泥渗漏率从少到多的顺序为CKP>CVP>UKP>BKP>UVP>BVP。X射线曝光时间从少到多的顺序是CKP>CVP>UVP>BVP>UKP>BKP。操作时间从少到多的顺序是CVP>UVP>UKP>CKP>BVP>BKP。
结论：对于后凸角度的患者，椎体后凸成形术在改善后凸角度方面具有独特的优势。但总的来说,弯曲入路可以通过单侧入路优化骨水泥的分布，达到双侧入路的矫形效果，是治疗OVCF的一种疗效较好、安全性较高的微创技术。
方法：发布，Embase,科克伦图书馆,Web的科学。文献检索数据库，检索时间从数据库建立到2023年4月,单侧椎体成形术(UVP)的随机对照试验,双侧椎体成形术(BVP),单侧椎体后凸成形术（UKP），双侧椎体后凸成形术(BKP),筛选弯曲椎体成形术（CVP）和弯曲椎体后凸成形术（CKP），评估并提取数据并纳入分析。使用STATA15.0和ReMan5.3进行数据分析。这项研究在美国国立卫生研究院（NIHR）注册，注册号为CRD42023405181。
结果：本研究共纳入16篇文献，共1712例患者。视觉模拟量表（VAS）改善从好到坏的顺序是CVP>BVP>UVP>CKP>BKP>UKP。后凸角改善从好到坏的顺序是CKP>UKP>UKP>UVP>BVP>CVP。骨水泥注入从少到多的顺序是UVP>CVP>UKP>CKP>BVP>BKP。骨水泥渗漏率从少到多的顺序为CKP>CVP>UKP>BKP>UVP>BVP。X射线曝光时间从少到多的顺序是CKP>CVP>UVP>BVP>UKP>BKP。操作时间从少到多的顺序是CVP>UVP>UKP>CKP>BVP>BKP。
结论：对于后凸角度的患者，椎体后凸成形术在改善后凸角度方面具有独特的优势。但总的来说,弯曲入路可以通过单侧入路优化骨水泥的分布，达到双侧入路的矫形效果，是治疗OVCF的一种疗效较好、安全性较高的微创技术。
