Comparison Between 7 Osteoporotic Vertebral Compression Fractures Treatments:Systematic Review and Network Meta-analysis

摘要：

　　■BACKGROUND:Vertebroplasty(VP),kyphoplasty(KP),SpineJack system(SJ),radiofrequency kyphoplasty(RFK),Kiva system(Kiva),Sky kyphoplasty system(SK),and conservative treatment are widely used in the treatment of osteoporotic vertebral compression fractures(OVCFs).However,it is still un-known which is the best intervention.The aim of the current study was to evaluate the effectiveness and safety of VP,KP,SJ,RFK,Kiva,SK,and CT in the treatment of OVCFs.■ METHODS:Randomized controlled trials and cohort studies comparing VP,KP,SJ,RFK,Kiva,SK,or CT for the treatment of OVCFs were identified on the basis of databases including PubMed,the Cochrane Library,Web of Science,and Springer Link.A network meta-analysis was performed using STATA 15.1.■ RESULTS:A total of 56 studies with 6974 patients and 7 interventions were included in this study.The results of the surface under the cumulative probability demonstrated that SK was the best intervention in decreasing VAS scores and recovering middle vertebral height,RFK was the best intervention in improving ODI scores and decreasing incidence of new fractures,SJ was the best inter-vention to restore kyphosis angle,and Kiva was the best intervention to reduce incidence of bone cement leakage.Cluster analysis showed that SK was the preferable intervention on the basis of the outcomes of VAS,ODI,middle vertebral height,and kyphotic angle,and RFK was the preferable treatment in decreasing the incidence of adverse events.In our network meta-analysis,node-splitting analysis and loop inconsistency analysis showed no significant inconsistencies.■ CONCLUSIONS:SK may be the most effective treatment in relieving pain,improving the quality of life,and recovering vertebral body height and kyphotic angle,while RFK may be the safest intervention for OVCFs.However,considering the limitations of this study,more high-quality trials are needed in the future to confirm the current conclusion.

关键词： Conservative treatment Network meta-analysis Osteoporotic vertebral compression fractures Vertebral augmentation technique

作者: Minmin Chang Chenchen Zhang Jing Shi Jian Liang Xin Yuan Honghao Huang Dong Li Binbin Yang Shujie Tang

作者单位: School of Chinese Medicine,Jinan University,Guangzhou,Guangdong Province,China

会议类型: 国际会议

会议名称: 第三届暨南大学粤港澳大湾区医学与健康发展分论坛——医学研究生学术论坛

会议地点: 广州

会议语种:英文

页码: 395-404

在线出版日期: 2020-11-28（万方平台首次上网日期，不代表论文的发表时间）