Comparison of clinical and radiological outcomes of vertebral body stenting versus percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis
Ting Zhang1*
, Yinxiao Peng2*, Jun Li2
1Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
2Department of Orthopaedic, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
Keywords: Meta-analysis, osteoporosis vertebral compression fracture, percutaneous kyphoplasty, vertebral body stenting.
Abstract
Objectives: The study aimed to compare the efficacy and safety of percutaneous kyphoplasty (PKP) and vertebral body stenting (VBS) in the treatment of osteoporotic vertebral compression fractures (OVCFs) and evaluate the clinical efficacy, Cobb angle correction, and cement leakage associated with both methods for OVCFs.
Patients and methods: A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Medline, China National Knowledge, and Wanfang Data for clinical studies comparing VBS with PKP for OVCF up to May 2023. The meta-analysis was performed using Review Manager 5.3, with a focus on evaluating clinical and radiologic outcomes.
Results: A total of eight eligible clinical studies were included in this meta-analysis. In terms of clinical outcomes, VBS was found to have a longer surgical time compared to PKP (standard mean difference [SMD]=1.06 min; 95% confidence interval [CI]: 0.20, 1.92; p=0.02). However, VBS demonstrated comparable blood loss to PKP (SMD =0.00 mL; 95% CI: –0.45, 0.45; p=0.99). Additionally, VBS showed slight superiority in alleviating back pain as measured by the Visual Analog Scale (VAS) (SMD=–0.38; 95% CI: –0.63, –0.12; p=0.004), as well as in improving functional disability based on the Oswestry Disability Index (ODI) (SMD= –0.28; 95% CI: –0.54, –0.03; p=0.03). Radiographically, VBS achieved better Cobb angle correction compared to PKP (SMD= –1.00; 95% CI: –1.48, –0.51; p<0.0001), while there was no significant difference in cement leakage between VBS and PKP (odds ratio=0.81; 95% CI: 0.21, 3.14; p=0.76).
Conclusion: The findings suggest that VBS has a comparable clinical outcome to PKP based on operation time, intraoperative blood loss, VAS, and ODI. Furthermore, VBS showed slightly better maintenance of Cobb angle correction, whereas VBS did not demonstrate a significant advantage over PKP in terms of cement leakage.
* The authors contributed equally to this study
Citation: Zhang T, Peng Y, Li J. Comparison of clinical and radiological outcomes of vertebral body stenting versus percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis. Jt Dis Relat Surg 2024;35(1):218-230. doi: 10.52312/ jdrs.2023.1356.
Participated in the study conception and design: T.Z., J.L.; Performed the systematic literature search, analyzed the data, drafted the manuscript and conducted the statistical review: T.Z., Y.X.P.; Critically reviewed the manuscript. All authors read and approved the final manuscript: J.L.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.