Affiliation:
1. 1 Department of Orthopedic Trauma, Peking University Third Hospital, Beijing, China
Abstract
Background: There have been many meta-analyses and systematic reviews that have discussed
the differences between unilateral and bilateral balloon kyphoplasty. However, their conclusions
regarding the efficacy and safety of bilateral balloon kyphoplasty in the treatment of osteoporotic
vertebral compression fractures (OVCFs) are discordant.
Objective: We attempted to select the best evidence review to determine the differences
between unilateral and bilateral balloon kyphoplasty, and we wanted to determine the best
treatment approach for OVCFs.
Study Design: A systematic review of overlapping meta-analyses
Setting: The electronic databases of PubMed, Embase and The Cochrane Library were searched.
The search extended through Sept. 30, 2017. Moreover, we manually searched the last 10 years of
conference reports and papers from the Peking University Health Science Library and consulted 2
experts in the field for any additional relevant information.
Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA) Statement and used “A Measurement Tool to Assess Systematic Reviews” (AMTASR) and
the Oxford Levels of Evidence to assess the methodological quality of the studies. We applied the
Jadad decision algorithm to select the best evidence review.
Results: Seven meta-analyses were included in this systematic review. The AMTASR scores of the
studies ranged from 4 to 9, with an average of 6. Finally, Sun H et al was shown to represent the
best evidence study. Sun H et al proposed that the unilateral kyphoplasty required less surgical time
and consumed less cement, reduced cement leakage, and improved short-term general health
compared with that of bilateral kyphoplasty.
Limitations: The AMTASR scores indicated that some of the included studies were of low
quality. In addition, not all of the studies used the Grading of Recommendations Assessment,
Development, and Evaluation (GRADE) level. When used, the GRADE level indicated that most of
the results consisted of studies of low quality.
Conclusions: Unilateral kyphoplasty reduces the operative time, cement volume, and cement
leakage rate compared with bilateral kyphoplasty. Therefore, we conclude that unilateral
kyphoplasty is more advantageous, effective and safe, compared to bilateral kyphoplasty for the
treatment of OVCFs.
Key words: Osteoporotic vertebral compression fracture, kyphoplasty, unilateral, bilateral,
unipedicular, bipedicular, systematic review
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
1 articles.
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