A systematic review of unilateral versus bilateral percutaneous vertebroplasty/percutaneous kyphoplasty for osteoporotic vertebral compression fractures

Abstract

Objective: The aim of this study was to compare the unilateral and bilateral approaches in treatingosteoporotic vertebral compression fractures.Methods: Based on the principles and methods of the Cochrane systematic reviews, the records of theCochrane Library, PubMed, Web of Science, Chinese Bio-medicine database, China Journal Full-textDatabase, VIP database, and Wanfang database were reviewed until October 2014. The randomizedcontrolled trials on unilateral and bilateral approaches to percutaneous vertebroplasty (PVP)/percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures were included. The risk of biasof included trials was assessed based on the Cochrane Handbook for Systematic Reviews of InterventionsVersion. The RevMan Software 5.0 was used for meta-analysis.Results: Fifteen randomized controlled trials with a total of 850 patients were included. Risk of bias inthe included studies was inevitable. There was no statistically signiŞcant difference in visual analog scale,vertebral height, kyphotic angular, and quality of life. The main operative complications were bonecement leakage and adjacent vertebral fracture, without difference between the two groups.Conclusions: In view of the current evidence, there is insufŞcient evidence to show any difference between the unilateral and bilateral approaches in both the PVP and PKP treatment in osteoporoticvertebral compression fractures.Level of Evidence: Level I, Therapeutic study.