Abstract
Background
To compare high- versus low-viscosity bone cement on the clinical outcomes and complications in patients with Osteoporotic vertebral compression fractures (OVCFs) who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).
Methods
PubMed, Embase, and the Cochrane Library were searched for papers published from inception up to February 2021 for potentially eligible studies comparing high- versus low-viscosity cement for PVP/PKP. The outcomes were the leakage rate, visual analog scale (VAS), and Oswestry Disability Index (ODI).
Results
Eight studies (558 patients; 279 in each group) were included. The meta-analysis showed that the leakage rate was lower with high-viscosity cement than with low-viscosity cement (OR = 0.23, 95%CI 0.14–0.39, P < 0.001; I2 = 43.5%, Pheterogeneity = 0.088); similar results were observed specifically for the disk space, paravertebral space, and peripheral vein, but there were no differences regarding the epidural space and intraspinal space. The VAS was decreased more significantly with high-viscosity cement than with low-viscosity cement (WMD = − 0.21, 95%CI − 0.38, − 0.04, P = 0.015; I2 = 0.0%, Pheterogeneity = 0.565). Regarding the ODI, there was no difference between high- and low-viscosity cement (WMD = − 0.88, 95%CI − 3.06, 1.29, P = 0.426; I2 = 78.3%, Pheterogeneity < 0.001).
Conclusions
There were lower cement leakage rates in PVP/PKP with high-viscosity bone cement than low-viscosity bone cement. The two groups have similar results in ODI, but the VAS scores favor high-viscosity bone cement. Therefore, the administration of high-viscosity bone cement in PVP/ PKP could be a potential option for improving the complications of leakage in OVCFs, while the clinical efficacy of relieving pain is not certain.
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Data availability
The dataset(s) supporting the conclusions of this article is(are) included within the article (and its additional file(s).
Abbreviations
- OVCFs:
-
Osteoporotic vertebral compression fractures
- PVP:
-
Percutaneous vertebroplasty
- PKF:
-
Percutaneous kyphoplasty
- VAS:
-
Visual analog scale
- ODI:
-
Oswestry disability index
- PKP:
-
Percutaneous kyphoplasty
- NOS:
-
Newcastle–Ottawa scale
- RCTs:
-
Randomized controlled trials
- SD:
-
Standard deviations
- ORs:
-
Odds ratios
- WMDs:
-
Weighted mean differences
- CIs:
-
Confidence intervals
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Funding
The study was supported by Beijing Hospital Clinical Research 121 Project (BJ-2018-203).
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QW analyzed and interpreted the patient data regarding osteoporotic vertebral compression fracture. QW performed the statistical analysis, and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.
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Wang, Q., Sun, C., Zhang, L. et al. High- versus low-viscosity cement vertebroplasty and kyphoplasty for osteoporotic vertebral compression fracture: a meta-analysis. Eur Spine J 31, 1122–1130 (2022). https://doi.org/10.1007/s00586-022-07150-w
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DOI: https://doi.org/10.1007/s00586-022-07150-w