Abstract：
Osteoporotic vertebral fractures frequently result in pain and decreased quality of life (QoL). The management of these fractures remains a topic of debate. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we analyzed randomized controlled trials comparing percutaneous vertebroplasty (PV) with non-operative treatment (non-OT). The outcomes of interest included pain, QoL, cement leakage, and new osteoporotic vertebral fractures after 1 year. Compared to non-OT regarding pain relief, PV yielded significant improvement at 1-2 weeks, 1 month, 6 months (standard mean difference [SMD] = -0.67 (6/14; 95% confidence interval [CI]: -1.29 to -0.06; I2 = 92%, random effects) and 1 year (mean difference = -1.07 (4/14; 95% CI: -1.97 to -0.18; I2 = 97%, random effects). For QoL, notable improvements were observed at 1 week (standard mean difference = -2.10 (5/14; 95% CI: -3.77 to -0.42; I2 = 98%, random effects) and 3 months (mean difference = -1.58 (4/14; 95% CI: -3.07 to -0.09; I2 = 96%, random effects), with 1 month, 6 months and 1 year being inconclusive. A cement leakage rate of 42% (10/14; 95% CI: 25% to 59%; I2 = 99%, random effects) was found. Further, PV did not significantly heighten the risk of new fractures within a year (odds ratio = 1.26 (6/14; 95% CI: 0.63 to 2.53; I2 = 74%, random effects). PV emerges as a promising intervention for specific time intervals regarding pain relief, especially in the extended-term analysis, and QoL, especially in the short-term analysis, compared to non-OT. However, clinicians must consider cement leakage risks. Heterogeneity among studies underscores careful patient selection.
摘要：
骨质疏松性椎体骨折（OVFs）经常导致疼痛和生活质量（QoL）下降。这些骨折的管理仍然是一个争论的话题。按照PRISMA准则,我们分析了比较PV和非手术治疗（非OT）的RCT。感兴趣的结果包括疼痛，QoL,水泥渗漏,和一年后的新OVF。与非OT相比，疼痛缓解，PV在1-2周显著改善，1个月,6个月（SMD=-0.67（6/14；95％CI：-1.29至-0.06；I2=92％，随机效应)和1年(MD=-1.07(4/14；95%CI：-1.97至-0.18；I2=97%，随机效应)。对于QoL，在1周时观察到显着改善（SMD=-2.10（5/14；95％CI：-3.77至-0.42；I2=98％，随机效应）和3个月（MD=-1.58（4/14；95%CI：-3.07至-0.09；I2=96%，随机效应)，1个月,6个月和1年没有定论。水泥渗漏率为42%(10/14;95%CI:25%至59%;I2=99%,随机效应)被发现。Further,PV并没有显着增加一年内新骨折的风险（OR=1.26（6/14;95％CI：0.63至2.53;I2=74％，随机效应)。PV作为一种有希望的干预措施，用于缓解疼痛的特定时间间隔，特别是在长期分析中，和QoL,特别是在短期分析中，与非OT相比。然而,临床医生必须考虑水泥渗漏的风险。研究之间的异质性强调了谨慎的患者选择。
