Weijian Chen1, Weixing Xie2, Zenglin Xiao1, Haoyan Chen1, Daxiang Jin3, Jinyong Ding2. 1. Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China. 2. Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China. 3. Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China. Electronic address: 642366579@qq.com.
Abstract
BACKGROUND: A meta-analysis of randomized controlled trials (RCTs) was performed to compare the incidence of cement leakage between unilateral and bilateral percutaneous vertebral augmentation (PVA) in treating osteoporotic vertebral compression fractures (OVCFs). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to retrieve the reported data from the establishment of the databases until August 1, 2018. The RCTs on unilateral and bilateral PVA for OVCFs were included. RevMan software, version 5.3, was used for the meta-analysis. RESULTS: Six RCTs were selected from the reported data. The studies included a total of 676 vertebras, 339 of which had received unilateral PVA and the rest, bilateral PVA. The incidence of cement leakage in the unilateral PVA group was less than that in the bilateral PVA group, and the difference between the 2 groups was statistically significant (risk ratio, 0.50; 95% confidence interval, 0.35-0.72; P = 0.0002). The cement dosage in the unilateral PVA group was less than that in the bilateral PVA group, and the difference between the 2 groups was statistically significant (weighted mean difference, -1.98; 95% confidence interval, -2.24 to -1.72; P < 0.00001). The cement dosage and the incidence of cement leakage in the unilateral PVA group were lower than those in the bilateral PVA group. CONCLUSIONS: The results of our meta-analysis have provided sufficient evidence to show that the unilateral approach can decrease the incidence of cement leakage in PVA. We believe the unilateral approach could reduce the risk of cement leakage owing to the lower cement dosage in the treated vertebra.
BACKGROUND: A meta-analysis of randomized controlled trials (RCTs) was performed to compare the incidence of cement leakage between unilateral and bilateral percutaneous vertebral augmentation (PVA) in treating osteoporotic vertebral compression fractures (OVCFs). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to retrieve the reported data from the establishment of the databases until August 1, 2018. The RCTs on unilateral and bilateral PVA for OVCFs were included. RevMan software, version 5.3, was used for the meta-analysis. RESULTS: Six RCTs were selected from the reported data. The studies included a total of 676 vertebras, 339 of which had received unilateral PVA and the rest, bilateral PVA. The incidence of cement leakage in the unilateral PVA group was less than that in the bilateral PVA group, and the difference between the 2 groups was statistically significant (risk ratio, 0.50; 95% confidence interval, 0.35-0.72; P = 0.0002). The cement dosage in the unilateral PVA group was less than that in the bilateral PVA group, and the difference between the 2 groups was statistically significant (weighted mean difference, -1.98; 95% confidence interval, -2.24 to -1.72; P < 0.00001). The cement dosage and the incidence of cement leakage in the unilateral PVA group were lower than those in the bilateral PVA group. CONCLUSIONS: The results of our meta-analysis have provided sufficient evidence to show that the unilateral approach can decrease the incidence of cement leakage in PVA. We believe the unilateral approach could reduce the risk of cement leakage owing to the lower cement dosage in the treated vertebra.