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2022, Vol. 26 ›› Issue (3): 487-492Meta-analysis of efficacy and safety of Jack kyphoplasty for osteoporotic vertebral compression fracturesZhong Yuanming1, He Bingkun2, Wu Zhuotan2, Wu Sixian2, Wan Tong2, Zhong Xifeng2
Abstract: OBJECTIVE: Both Jack kyphoplasty and balloon kyphoplasty have satisfactory results in the treatment of osteoporotic vertebral compression fractures. However, whether the two methods are better or not is still controversial. Thus, this study systemically evaluated the efficacy and safety of Jack vertebral dilator-kyphoplasty and balloon-kyphoplasty in the treatment of osteoporotic vertebral compression fracture. METHODS: Wanfang, VIP, CNKI, PubMed, EMBASE, the Cochrane Library, CBM and other databases were searched by computer before July 2020. The clinical controlled studies on Jack kyphoplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral compression fracture were collected. After two evaluators independently selected literature, extracted data and evaluated the quality of methodology included in the study (according to Cochrane Handbook and NOS scale), meta-analysis was carried out by using Stata/SE 12.0 software. RESULTS: (1) Seven articles were included; the quality of the three randomized controlled trial articles was grade B, and the NOS scores of four cohort studies were greater than 5. A total of 473 patients were included in the final analysis, including 229 cases in Jack kyphoplasty group and 244 cases in balloon kyphoplasty group. (2) The results of meta-analysis showed that Jack kyphoplasty was better than balloon kyphoplasty in terms of Cobb angle (MD=-2.2, 95%CI:-4.07 to-0.36, P=0.001). Jack kyphoplasty was higher than balloon kyphoplasty in terms of anterior vertebral height (MD=2.02, 95%CI:1.08-2.96, P=0.000). Jack kyphoplasty was lower than balloon kyphoplasty in terms of cement leakage rate (RR=0.32, 95%CI:0.15-0.68, P=0.003). There were no significant differences in postoperative visual analogue scale score (MD=-0.07, 95%CI:-0.26-0.13, P > 0.05), bone cement injection (MD=-0.08, 95%CI:-0.21-0.06, P > 0.05], operation time (MD=-0.51, 95%CI:-4.85-3.83, P > 0.05], and intraoperative blood loss (MD=0.44, 95%CI:-0.47-1.35, P > 0.05) between the two groups. CONCLUSION: Compared with balloon kyphoplasty, Jack kyphoplasty has more advantages in reducing Cobb angle, improving anterior height of vertebral body and reducing cement leakage rate. However, this conclusion still needs to be further confirmed by large-sample and multi-center randomized controlled trials. Key words:bone, vertebral body, fracture, bone cement, compression fracture, osteoporosis, bone cement leakage rate, meta-analysis |