CAJ | 학술논문

背景：球囊椎体后凸成形可有效治疗骨质疏松引起的椎体压缩性骨折，但对于采用单侧还是双侧入路哪种入路疗效更佳、并发症更少，目前尚无定论。 　　目的：系统评价单侧与双侧穿刺入路椎体后凸成形治疗骨质疏松性椎体压缩性骨折的疗效和安全性。 　　方法：应用计算机检索PubMed、EMBASE、Cochrane Library、ISI Web of Knowledge、CBM等数据库1963年1月至2014年3月文献，收集单侧对比双侧入路椎体后凸成形治疗骨质疏松性椎体压缩性骨折的随机对照试验，由2名评价者独立评价纳入研究的质量并提取资料，并用RevMan 5.2软件进行统计分析。 　　结果与结论：共纳入14个随机对照试验，共876例患者，其中单侧入路组442例，双侧入路组434例。Meta分析结果显示，单侧入路组手术时间、单个椎体平均注射骨水泥及骨水泥渗漏率少于双侧入路组[均数差MD=-19.33，95%可信区间(-24.42，-14.24)；均数差MD=-2.07，95%可信区间(-2.42，-1.71)；OR=0.47，95%可信区间(-24.42，-14.24)]；两组目测类比评分、椎体高度变化及 Cobb 角变化方面的差异无显著性意义。结果说明在椎体后凸成形治疗中，单侧入路可减少骨水泥渗漏率。
배경：구낭추체후철성형가유효치료골질소송인기적추체압축성골절，단대우채용단측환시쌍측입로나충입로료효경가、병발증경소，목전상무정론。 　　목적：계통평개단측여쌍측천자입로추체후철성형치료골질소송성추체압축성골절적료효화안전성。 　　방법：응용계산궤검색PubMed、EMBASE、Cochrane Library、ISI Web of Knowledge、CBM등수거고1963년1월지2014년3월문헌，수집단측대비쌍측입로추체후철성형치료골질소송성추체압축성골절적수궤대조시험，유2명평개자독립평개납입연구적질량병제취자료，병용RevMan 5.2연건진행통계분석。 　　결과여결론：공납입14개수궤대조시험，공876례환자，기중단측입로조442례，쌍측입로조434례。Meta분석결과현시，단측입로조수술시간、단개추체평균주사골수니급골수니삼루솔소우쌍측입로조[균수차MD=-19.33，95%가신구간(-24.42，-14.24)；균수차MD=-2.07，95%가신구간(-2.42，-1.71)；OR=0.47，95%가신구간(-24.42，-14.24)]；량조목측류비평분、추체고도변화급 Cobb 각변화방면적차이무현저성의의。결과설명재추체후철성형치료중，단측입로가감소골수니삼루솔。
BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer complications. OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software. RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24); MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.