Comparison of the Efficacy Between Two Micro-Operative Therapies of Old Patients With Osteoporotic Vertebral Compression Fracture: A Network Meta-Analysis.

Osteoporotic vertebral compression fracture (OVCF) afflicts most aged people. Except for conservative therapy (CT), percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are another two the common choices, but current evaluation of their efficacy is not performed. All the trial data were originated from electronic database including PubMed, Embase, and Cochrane Library. Four indicators with mean difference (MD) or odd ratio (OR) with their 95% credible interval (95% CrI) were analyzed to evaluate the efficacy, including the value of visual analog scale (VAS), Oswestry disability index (ODI), relieving kyphotic angle (KA), and rate of fracture. Besides, the results were demonstrated in the forest plots and slash tables. Furthermore, the surface under the cumulative ranking curve (SUCRA) was calculated. A total of 32 trials among 2,852 patients are included. Using network comparison, we found that PKP and PVP both have good performance as OVCF treatments. However, in different aspects, PKP seemed to be the best to eliminate pain with high value of SUCRA on ODI and VAS (0.624 and 0.588, respectively), and PVP had better performance in KA and decreasing incidence of fracture. The micro-operative therapy, both PKP and PVP, had better efficacy than CT in four aspects. And PKP was better in pain alleviating, according to VAS and ODI results, while PVP had the superiority in KA and reducing the incidence of fracture. J. Cell. Biochem. 118: 3205-3212, 2017.