Turkish Neurosurgery 2022 , Vol 32 , Num 6
Cement Leakage in Vertebral Compression Fractures Between Unilateral and Bilateral Percutaneous Vertebral Augmentation: A Meta-Analysis
Xinzhe MA1,Hui SUN2,Shizhao LIU3,Linchao SANG1,Kunlong WANG4,Yue DONG5,Xiangbei QI6
1The Second Department of Trauma, the Third Hospital of Shijiazhuang, Shijiazhuang, China
2Oita University Faculty of Medicine
3Hebei Hospital of Traditional Chinese Medicine, Department of Emergency, Shijiazhuang, China
4The People Hospital of Gongyi City, Department of Orthopaedic Surgery, Gongyi, China
5Baoding First Central Hospital, Department of Orthopedic, Baoding, China
6The Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, China
7Tiemenguan District of the Third Hospital of Hebei Medical University, Department of Orthopedics, Shijiazhuang, China
DOI : 10.5137/1019-5149.JTN.37319-21.4 AIM: To compare the incidences of cement leakage between unilateral and bilateral percutaneous vertebral augmentation (PVA) in the treatment of osteoporosis vertebral compression fractures, a meta-analysis was performed.

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 randomeffects 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 randomized controlled trials 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. Keywords : Percutaneous vertebral augmentation, Cement leakage, Meta-analysis, Vertebral compression fractures

Corresponding author : Xiangbei QI, qixiangbei126@126.com