Turkish Neurosurgery
Cement leakage in vertebral compression fractures between unilateral and bilateral percutaneous vertebral augmentation: a meta-analysis
Ma Xinzhe1, Sun Hui2, Li Shizhao3, Sang Linchao 1, Wang Kunlong4, Dong Yue 5, Qi Xiangbei6
1the Third Hospital of Shijiazhuang, The Second Department of Trauma, Shijiangzhuang,
2Oita University Faculty of Medicine, --, --,
3Hebei Hospital of traditional Chinese Medicine, Department of Emergency,, Shijiangzhuang,
4the people Hospital of Gongyi city, Department of Orthopaedic Surgery, Gongyi,
5Baoding First Central Hospital,, Department of Orthopedic, Baoding,
6 the Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiangzhuang,
7 Tiemenguan District of the Third Hospital of Hebei Medical University, Department of Orthopedics,, Shijiangzhuang,
DOI: 10.5137/1019-5149.JTN.37319-21.4
Aim: Cement leakage remains a significant clinical problem associated with vertebroplasty and kyphoplasty procedures, with uncontrolled cement flow in the posterior direction causing leakage into the vertebral veins or spinal canal that leads to potentially serious clinical complications. This meta-analysis compared the incidences of cement leakage between unilateral and bilateral percutaneous vertebral augmentation (PVA) in the treatment of osteoporosis vertebral compression fractures. Material and Methods: Pertinent studies were identified by a search of the PubMed, Embase, and Web of Science databases up to December 2020. The risk ratio (RR) or weighted mean difference (WMD) was applied to combine the results, and a random-effects or a fixed-effects model was used to pool the results depending on the heterogeneity among studies. Publication bias was estimated using Egger’s regression asymmetry test.Results: A total of 16 trials (including 9 RCTs and 7 cohort studies) met the inclusion criteria and were included in this meta-analysis. The incidences of cement leakage were similar between the bilateral PVA and unilateral PVA groups (RR = 0.80, 95%CI: 0.57, 1.11; P = 0.182) but unilateral PVA required less cement volume (WMD = −1.34 ml, 95%CI: −1.87, −0.81; P < 0.001). Subgroup analysis revealed that the incidence of cement leakage was significantly lower in the unilateral PKP group than in the bilateral PKP group (RR = 0.65, 95%CI: 0.44, 0.97; P = 0.034). Conclusion:The incidences of cement leakage were similar between unilateral and bilateral PVA, but unilateral PVA required less cement. More large-scale studies are needed to verify our findings.
Corresponding author : Qi Xiangbei