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Comparing pain reduction following kyphoplasty and vertebroplasty

A meta-analysis of randomized and non-randomized controlled trials

Vergleich der Schmerzreduktion nach Kypho- und Vertebroplastie

Eine Metaanalyse randomisierter und nichtrandomisierter kontrollierter Studien

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Abstract

Purpose

The aim of the study was to compare the extent of pain reduction with kyphoplasty (KP) and vertebroplasty (VP) in the treatment of osteoporotic vertebral compression fractures (OVCF) using a visual analog scale (VAS).

Methods

A computerized database search was performed to compare pain relief from VP and KP in OVCF. The available literature was analysed to quantify the amount of pain reduction using VAS as the primary outcome.

Results

A total of 10 studies encompassing 902 patients met the inclusion criteria. Subgroup meta-analyses were performed according to the study design. VAS for the KP group was not significant compared with the VP group at 1 week, 1 month, and 6 months. Pain relief in the KP group was greater than that in the VP group at 12 months and 2 years.

Conclusion

KP is superior to VP in patients requiring pain relief. More large-scale, double-blinded controlled trials are necessary in order to quantify the pain relief afforded by VP more precisely.

Zusammenfassung

Analyseziel

Ziel der Analyse war ein Vergleich der Schmerzreduktion nach Behandlung osteoporotischer Wirbelkompressionsfrakturen (OVCF, „osteoporotic vertebral compression fracture“) mit Kyphoplastie (KP) und mit Vertebroplastie (VP) unter Nutzung der visuellen Analogskala (VAS).

Methoden

Die Autoren durchsuchten computerunterstützt Datenbanken bezüglich Arbeiten zur Schmerzreduktion nach mittels VP bzw. KP behandelten OVCF. Die verfügbare Literatur wurde auf Nutzung der VAS zur Bestimmung der Schmerzreduktion als primären Endpunkt überprüft.

Ergebnisse

Insgesamt 10 Arbeiten mit 902 Patienten erfüllten die Einschlusskriterien. Subgruppenanalysen erfolgten entsprechend dem Studiendesign. Die VAS-Ergebnisse nach KP zeigten zu den Zeitpunkten 1 Woche, 1 Monat und 6 Monate keine signifikanten Unterschiede im Vergleich zu den mit VP behandelten Patienten. Nach 12 Monaten und 2 Jahren war die Schmerzreduktion bei den mit KP vs. mit VP behandelten Patienten ausgeprägter.

Schlussfolgerung

Die KP ist der VP bezüglich der Schmerzreduktion überlegen. Um die Schmerzverminderung nach VP genauer bestimmen zu können, sind mehr Daten aus größer angelegten, kontrollierten Doppelblindstudien nötig.

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Abbreviations

CI:

Confidence interval

CPGS:

Chronic pain grade scale

KP:

Kyphoplasty

MD:

Mean difference

MPQ:

McGill pain questionnaire

NRS:

Numeric rating scale

OVCF:

Osteoporotic vertebral compression fractures

RCT:

Randomized controlled trials

RR:

Risk ratio

VAS:

Visual analog scale

VP:

Vertebroplasty

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Authors and Affiliations

  1. Department of Orthopaedics, Yanling Hospital of Traditional Chinese Medicine, 27 Huadudadao Road, 461000, Yanling, Henan, China

    Chen Chen

  2. Department of Orthopaedics, Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine, 889 Wuzhongxi Road, 215009, Suzhou, Jiangsu, China

    Xiaofeng Shen, Jiangping Wang, Zhigang Zhang, Yuwei Li & Hua Chen

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Correspondence to Hua Chen.

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Conflict of interest

C. Chen, X. Shen, J. Wang, Z. Zhang, Y. Li and H. Chen declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors. For the studies discussed here the ethical guidelines are declared in the respective papers.

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Chen, C., Shen, X., Wang, J. et al. Comparing pain reduction following kyphoplasty and vertebroplasty. Orthopäde 46, 855–863 (2017). https://doi.org/10.1007/s00132-017-3455-x

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