Comparison of clinical and radiological outcomes of vertebral body stenting versus percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fracture: A systematic review and meta-analysis

Abstract

Objectives The study aimed to compare the efficacy and safety of percutaneous kyphoplasty (PKP) and vertebral body stenting (VBS) in the treatment of osteoporotic vertebral compression fractures (OVCFs) and evaluate the clinical efficacy, Cobb angle correction, and cement leakage associated with both methods for OVCFs. Patients and methods A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Medline, China National Knowledge, and Wanfang Data for clinical studies comparing VBS with PKP for OVCF up to May 2023. The meta-analysis was performed using Review Manager 5.3, with a focus on evaluating clinical and radiologic outcomes. Results A total of eight eligible clinical studies were included in this meta-analysis. In terms of clinical outcomes, VBS was found to have a longer surgical time compared to PKP (standard mean difference [SMD]=1.06 min; 95% confidence interval [CI]: 0.20, 1.92; p=0.02). However, VBS demonstrated comparable blood loss to PKP (SMD =0.00 mL; 95% CI: –0.45, 0.45; p=0.99). Additionally, VBS showed slight superiority in alleviating back pain as measured by the Visual Analog Scale (VAS) (SMD=–0.38; 95% CI: –0.63, –0.12; p=0.004), as well as in improving functional disability based on the Oswestry Disability Index (ODI) (SMD= –0.28; 95% CI: –0.54, –0.03; p=0.03). Radiographically, VBS achieved better Cobb angle correction compared to PKP (SMD= –1.00; 95% CI: –1.48, –0.51; p<0.0001), while there was no significant difference in cement leakage between VBS and PKP (odds ratio=0.81; 95% CI: 0.21, 3.14; p=0.76). Conclusion The findings suggest that VBS has a comparable clinical outcome to PKP based on operation time, intraoperative blood loss, VAS, and ODI. Furthermore, VBS showed slightly better maintenance of Cobb angle correction, whereas VBS did not demonstrate a significant advantage over PKP in terms of cement leakage.

Retrospective Cohort Study of Early versus Delayed Ballon Kyphoplasty Intervention for Osteoporotic Vertebral Fracture Treatment

“…The elderly population most commonly experiences OVFs, resulting in significant pain and a notable decline in quality of life [19,20]. Conservative management, as well as percutaneous vertebroplasty (PVP), balloon kyphoplasty (BKP) and vertebral body stenting (VBS), is employed for their treatment [21]. Several factors drive the preference for conservative management as the initial choice for osteoporotic vertebral fractures (OVFs).…”

Research Progress of Paraspinal Muscle Fat Infiltration in Osteoporotic Vertebral Compression Fractures

“…Although percutaneous vertebroplasty (PVP) has become the main treatment for such diseases, this minimally invasive treatment not only significantly reduces patients' pain, but also achieves satisfactory correction of kyphosis deformity [33] . However, a large proportion of patients still use traditional conservative treatments, such as bed rest, narcotic analgesics, and the use of thoracolumbar braces.…”