Comparison of the efficacy and safety of 3 treatments for patients with osteoporotic vertebral compression fractures

Zhao, Song; Xu, Chang-yan; Zhu, Ao-ran; Long, Youming; Lv, Longlong; Chen, Long; Huang, Qi; Niu, Feng

doi:10.1097/md.0000000000007328

Cited by 26 publications

(22 citation statements)

References 47 publications

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“…Previously, a number of studies have explored the clinical efficacy and costs of PVP/PKP in China based on hospital data. Evidence showed that PVP/PKP can effectively relieve fracture-related pain, and PVP/PKP is considered as the best choice for OVCF [1,[15][16][17]. Nevertheless, regardless of OVCF intervention modality, PVP/PKP surgery is very expensive and can impose a heavy financial burden on patients.…”

Section: Osteoporotic Vertebral Compression Fractures (Ovcf)mentioning

confidence: 99%

Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study

Yang

Zhang

et al. 2020

BMC Musculoskelet Disord

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Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate the re-surgery rate.

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Section: Osteoporotic Vertebral Compression Fractures (Ovcf)mentioning

confidence: 99%

Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study

Yang

Zhang

et al. 2020

BMC Musculoskelet Disord

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“…Six RCTs included patients with less than 8 weeks of symptoms. 22,24,[28][29][30][31]32 Six studies included patients with more than 8 weeks and up to 12 months of symptoms. 6,7,23,[25][26][27] Six of the 12 RCTs did not specify the baseline pain score as their inclusion criteria.…”

Section: The Canadian Journal Of Neurological Sciencesmentioning

confidence: 99%

“…Multiple reviews have assessed the efficacy of vertebroplasty for the treatment of back pain from osteoporotic VCF in RCTs, 12,32,[34][35][36][37][38][39][40][41][42][43] with some of them including non-RCTs. [35][36][37] These reviews showed the efficacy of vertebroplasty in improvement of pain compared to conservative management, but a systematic review of poorly designed cohort studies and non-RCTs generates only low quality of evidence in favour of vertebroplasty.…”

Section: How Is This Different From Other Reviews?mentioning

confidence: 99%

“…This raised the possibility of placebo effect from vertebroplasty. The two early sham studies 6,12 and another recent sham study 32 used sham procedure with infiltration of periosteum, which by itself could give pain relief. Thus, sham procedure was too aggressive and simulates the intervention.…”

Section: How Is This Different From Other Reviews?mentioning

confidence: 99%

“…More recent systematic reviews 32,[41][42][43] with recent RCTs showed pain relief was better with vertebroplasty compared to conservative management. This was supported by our systematic review and meta-analysis of all RCTs comparing vertebroplasty with conservative or sham treatments published to date.…”

Section: How Is This Different From Other Reviews?mentioning

confidence: 99%

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Imaging Improves Efficacy of Vertebroplasty – A Systematic Review and Meta-Analysis

Shankar

Merdad

Finitsis

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Background:Clinical trials with percutaneous vertebral augmentation (PVA) for intractable pain from vertebral compression fractures (VCF) have shown variable results. Variation in the outcomes may be related to poor patient selection on imaging.Objective:To assess if PVA augmentation for osteoporotic VCF results in better improvement in pain when patients were selected based on clinical examination plus imaging vs clinical examination only.Results:A systematic review and meta-analysis were performed. PubMed, Embase and Cochrane Library databases were searched from 2000 to May 2018. Two reviewers independently screened and extracted data to identify randomised control trials (RCTs) on PVA for osteoporotic VCF and assessed the risk of bias. Standard systematic review and meta-analysis methods were advocated by the Cochrane Collaboration and PRISMA Statement. A total of 12 RCTs with 1110 participants met the inclusion criteria. Eight of the 10 studies (938 participants) that used imaging to confirm oedema in the target vertebral bodies showed PVA (compared to nonsurgical treatment) was effective in reducing pain (immediate term: mean difference (MD) of −1.89; 95% confidence interval −1.93 to −1.85, p < 0.001; short term: MD of −1.68; 95% CI −1.82 to −1.54, p < 0.001; intermediate term: MD of −2.04; 95% CI −2.15 to −1.94, p < 0.001 and long term: MD of −1.88; 95% CI −1.95 to −1.80, p < 0.001).Conclusions:RCTs using imaging to confirm marrow oedema in the index vertebra showed an improved size effect compared to RCTs using no imaging. This benefit was observed in the immediate, short, intermediate and long term.

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Vertebral Augmentation for Painful Vertebral Compression Fractures

McJunkin

Lynch

Swing

2019

Deer's Treatment of Pain

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Comparison of the efficacy and safety of 3 treatments for patients with osteoporotic vertebral compression fractures

Abstract: Supplemental Digital Content is available in the text

Cited by 26 publications

References 47 publications

Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study

Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study

Imaging Improves Efficacy of Vertebroplasty – A Systematic Review and Meta-Analysis

Vertebral Augmentation for Painful Vertebral Compression Fractures

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