中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (13): 2366-2370.doi: 10.3969/j.issn.1673-8225.2011.13.021

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

注入骨水泥椎体成形与非手术治疗骨质疏松性椎体压缩骨折的Meta分析

徐建成1，白靖平1，锡林宝勒日1，何祖胜1，江仁兵1，黄卫民2   

  1. 1新疆医科大学附属肿瘤医院骨科，新疆维吾尔族自治区乌鲁木齐市　830011
    2新疆医科大学第六附属医院脊柱外科，新疆维吾尔族自治区乌鲁木齐市830011
  • 收稿日期:2010-11-21 修回日期:2010-12-30 出版日期:2011-03-26 发布日期:2013-10-23
  • 通讯作者: 白靖平，教授，博士生导师，新疆医科大学附属肿瘤医院骨科，新疆维吾尔自治区乌鲁木齐市 830011 08xjc@sina.com
  • 作者简介:徐建成★，男，1977年生，甘肃省武威市人，汉族，新疆医科大学在读硕士，主要从事以循证骨科学为主要的研究。 08xjc@sina.com

Vertebroplasty injected with bone cement versus non-operative treatment for osteoporotic vertebral compression fractures: A Meta-analysis

Xu Jian-cheng1, Bai Jing-ping1, Xilin Baoleri1, He Zu-sheng1, Jiang Ren-bing1, Huang Wei-min2   

  1. 1Department of Orthopaedics, Tumor Hospital of Xinjiang Medical University, Urumqi  830011, Xinjiang Uygur Autonomous Region, China
    2Department of Spine Surgery, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi  830011, Xinjiang Uygur Autonomous Region, China
  • Received:2010-11-21 Revised:2010-12-30 Online:2011-03-26 Published:2013-10-23
  • Contact: Bai Jing-ping, Professor, Doctoral supervisor, Department of Orthopaedics, Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China 08xjc@sina.com
  • About author:Xu Jian-cheng★, Studying for master’s degree, Department of Orthopaedics, Tumor Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China 08xjc@sina.com

PDF

674

被引次数

20

摘要：

背景：注入骨水泥椎体成形或称经皮椎体成形术作为治疗骨质疏松性椎体压缩骨折的微创技术，一些病例报道及非随机对照研究揭示了椎体成形对骨质疏松性椎体压缩骨折引起的疼痛有效。然而，这些研究主要基于回顾性的病例分析，缺乏高质量的随机对照研究。
目的：通过系统评价Meta分析的方法对椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的疗效进行评价。
方法：计算机检索Cochrane Library(2010年第4期) 、PubMed (1966/2010-11)、EMBASE(1974/2010-11)、CBM (1978/2010-11)、CNKI(1994/2010-11)、和万方数据库(1997/2010-11)。纳入椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的随机对照试验，按照Cochrane Handbook 5.0 进行严格的质量评估，采用RevMan 5.0.1软件进行Meta分析。
结果与结论: 共纳入4个随机对照试验，共445例患者。Meta分析结果显示，与保守治疗比较，随访1，4，24，48 周时椎体成形术在缓解疼痛方面更明显，在新发骨折发生方面，两种治疗方法没有差别；与安慰剂相比，随访4周时椎体成形术在缓解疼痛、提高腰部功能活动及改善生活质量方面并无明显优势。受系统评价纳入研究数量以及质量的限制，上述结论尚需要更多高质量的随机对照试验进一步验证。

关键词: 骨水泥, 椎体成形术, 椎体压缩骨折, 随机对照试验, Meta分析

Abstract:

BACKGROUND: Vertebroplasty injected with bone cement or percutaneous vertebroplasty as the minimally invasive technique in treatment of osteoporotic vertebral compression fracture. Some case reports and non-randomized controlled study revealed that vertebroplasty has an effect on pain caused by osteoporotic vertebral compression fractures. However, these studies are based on retrospective case analysis, lack of high-quality randomized controlled study.
OBJECTIVE: To evaluate the effectiveness of Meta-analysis method on vertebroplasty versus non-operative in treatment of osteoporotic vertebral compression fractures.
METHODS: A computer-based online search of Cochrane Library (the 4th period, 2010), PubMed database (1966/2011-11), EMBASE database (1974/2010-11), CBM database (1978/2010-11), CNKI database (1994/2010-11), and Wanfang database (1997/2010-11). Randomized controlled trials of vertebroplasty versus non-operative in treatment of osteoporotic vertebral compression fractures were included, and underwent strict quality assessment according to Cochrane Handbook 5.0. Meta-analysis was performed by RevMan 5.0.1 software.
RESULTS AND CONCLUSION: A total of 445 cases in 4 randomized controlled trials were included. Meta-analysis results showed that vertebroplasty in pain relief is more obvious than that in conservative treatment at 1, 4, 24, 48 weeks follow-up, but there were no significant differences in incidence of new fracture between the two groups. Compared with the placebo, there is no significant advantage for the vertebroplasty over the placebo in pain relief, the improvement of functional activities of waist, and quality of life. The above conclusions still needs more high-quality randomized controlled trails to be verified owing to the limitations of the number and quality of systematic review included studies.

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