A meta-analysis of balloon kyphoplasty compared to percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures

Abstract

A meta-analysis was conducted to assess the safety and efficacy of balloon kyphoplasty (KP) compared to percutaneous vertebroplasty (VP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Ten studies, encompassing 783 patients, met the inclusion criteria. Overall, the results of the meta-analysis indicated that there were significant differences between the two groups in the long-term kyphosis angle (mean difference [MD] = -2.64, 95% confidence interval [CI] = -4.66 to -0.61; p = 0.01), the anterior height of the vertebral body (MD = 3.67, 95% CI = 1.40 to 5.94; p = 0.002), and the cement leakage rates (risk ratio [RR] = 0.70, 95% CI = 0.52 to 0.95; p = 0.02). However, there were no significant differences in the short-term visual analog scale (VAS) scores (MD = -0.57, 95% CI -1.33 to 0.20; p = 0.15), the long-term VAS scores (MD = -0.99, 95% CI = -2.29 to 0.31; p = 0.14), the short-term Oswestry Disability Index (ODI) scores (MD = -6.54, 95% CI = -14.57 to 1.48; p = 0.11), the long-term ODI scores (MD=-2.01, 95% CI = -11.75 to 7.73; p = 0.69), the operation time (MD = 4.47, 95% CI = -0.22 to 9.17; p = 0.06), the short-term kyphosis angle (MD = -2.25, 95% CI = -5.14 to 0.65; p = 0.13), or the adjacent-level fracture rates (RR = 1.52, 95% CI = 0.76 to 3.03; p = 0.24). This meta-analysis demonstrates that KP and VP are both safe and effective surgical procedures for treating OVCF. Compared with VP, KP can significantly relieve a long-term kyphosis angle, improve the height of the vertebral body, and reduce the incidence of bone cement leakage. However, because of the limitations of this meta-analysis, a large randomized controlled trial is required to confirm our findings.