椎体成形术和球囊扩张后凸成形术治疗骨质疏松性椎体骨折有效性和安全性的meta分析

发布时间：2019-03-16 18:28

【摘要】：背景椎体成形术和球囊扩张后凸成形术是两种治疗骨质疏松性骨折的经典微创手术方式,而近些年来关于两种手术方式的手术效果和并发症方面的争议一直存在。方法在数据库中检索关于对比椎体成形术和球囊扩张后凸成形术治疗骨质疏松性椎体骨折的手术效果和并发症方面的文献,包括随机对照实验、临床对照实验以及队列分析。提取基本信息、临床数据、影像学数据、并发症分析进行荟萃分析。结果共21项研究,1713名患者的数据资料纳入研究分析,其中椎体成形组869人,球囊扩张后凸成形组844人,两组患者的疼痛评分近远期效果无差异,椎体成形术组手术所需时间更少,球囊扩张后凸成形术组能更好地恢复伤椎的高度和矫正后凸畸形。从并发症看,骨水泥向椎间盘渗漏的概率两个手术组没有差异,但是总的骨水泥渗漏率和椎旁骨水泥渗漏率球囊扩张后凸成形术的发生率更低。结论椎体成形术和球囊扩张后凸成形术都能有效缓解临床症状,但椎体成形手术时间更短,因此,对于不能忍受长时间的手术的患者而言可能更适合选择椎体成形手术。但球囊扩张后凸成形术在恢复椎体的高度和矫正后凸畸形方面更具有优势,而且骨水泥发生渗漏的概率更低,对于那些椎体高度丢失明显、严重后凸畸形的患者,球囊后凸成形术可能是更安全的选择。此外,椎体成形术更高的骨水泥渗漏概率可能主要是由于椎旁渗漏更高引起的。
[Abstract]:Background Vertebroplasty and balloon dilated kyphoplasty are two classical minimally invasive methods for the treatment of osteoporotic fractures, but in recent years there has been controversy about the effects and complications of the two methods. Methods in the database, we searched the literature about the effects and complications of vertebroplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral fractures, including randomized controlled trials, clinical controlled trials and cohort analysis. Extraction of basic information, clinical data, imaging data, complications analysis for meta-analysis. Results A total of 21 studies were conducted. The data of 1713 patients were included in the study. There were 869 patients in vertebroplasty group and 844 patients in balloon dilated kyphoplasty group. There was no significant difference in pain scores between the two groups. The operation time of vertebroplasty group was less. Balloon dilated kyphoplasty group could recover the height of injured vertebra and correct kyphosis better. There was no difference in the probability of bone cement leakage to intervertebral disc between the two groups from complications, but the overall bone cement leakage rate and paravertebral cement leakage rate were lower in balloon dilated kyphoplasty. Conclusion both vertebroplasty and balloon kyphoplasty can effectively relieve the clinical symptoms, but the time of vertebroplasty is shorter. Therefore, vertebroplasty may be more suitable for patients who cannot endure long-term surgery. But balloon dilated kyphoplasty has the advantage in restoring the height of vertebral body and correcting kyphosis deformity, and the probability of bone cement leakage is lower. For those patients whose vertebral body height is lost obviously and severe kyphosis deformity, Balloon kyphoplasty may be a safer option. In addition, the higher probability of bone cement leakage in vertebroplasty may be mainly due to higher paravertebral leakage.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【相似文献】