DG Journal Club
METHODS We comprehensively searched PubMed, Embase, Web of Science, and the Cochrane Library and performed a systematic review and cumulative meta-analysis of all randomized controlled trials and retrospective comparative studies assessing these important indexes of 2 methods using Review Manager 5.4.
RESULTS Four randomized controlled trials and 4 retrospective studies including 2335 cases were identified. Vertebroplasty combined with ZOL was associated with benefits from decreased pain (weighted mean difference [WMD] -0.43; 95% confidence interval [CI]-0.59 to -0.27; P<0.05), increased function (WMD -4.94; 95% CI -6.13 to -3.75; P<0.05), increased BMD of the vertebral body(WMD 0.85; 95% CI 0.30-1.40; P<0.05) and of the proximal femoral neck (WMD 0.14; 95% CI 0.08-0.21; P<0.05), fewer markers of bone metabolism (N-terminal molecular fragment: WMD -4.82; 95% CI -6.08 to -3.55; P<0.05; procollagen type I N-terminal propeptide: WMD -17.31; 95% CI -18.04 to -16.58; P<0.05; beta collagen degradation product: WMD -0.27; 95% CI -0.35 to -0.19; P<0.05), and lower rate of refracture (1.54% and 12.6%; odds ratio 0.17; 95% CI 0.08-0.36; P<0.05). Patients in the vertebroplasty combined with ZOL group had greater vertebral body height (WMD 2.17; 95% CI 0.72-3.62; P<0.05) than in the vertebroplasty group, but no differences on Cobb angle were observed (WMD -1.18; 95% CI -2.47 to 0.10; P>0.05).
CONCLUSIONS Vertebroplasty combined with ZOL was superior to vertebroplasty alone in terms of BMD, bone metabolism makers, refracture rate, pain and function.
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