Vertebral augmentation plus short-segment fixation versus vertebral augmentation alone in Kümmell’s disease: a systematic review and meta-analysis
| Autor: | Andrei Fernandes Joaquim, Juan P. Cabrera, Charles A Carazzo, Alfredo Guiroy, Gaston Camino-Willhuber, Martín Gagliardi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual analogue scale Osteoporosis Fractures Compression medicine Humans Kyphoplasty Retrospective Studies Fixation (histology) Vertebroplasty business.industry Bone Cements Retrospective cohort study General Medicine medicine.disease Surgery Oswestry Disability Index Treatment Outcome Meta-analysis Concomitant Spinal Fractures Neurology (clinical) Neurosurgery business Osteoporotic Fractures |
| Zdroj: | Neurosurgical Review. 45:1009-1018 |
| ISSN: | 1437-2320 |
| Popis: | Osteoporotic vertebral compression fractures of the thoracolumbar spine can progress to Kummell’s disease, an avascular vertebral osteonecrosis. Vertebral augmentation (VA)—vertebroplasty and/or kyphoplasty—is the main treatment modality, but additional short-segment fixation (SSF) has been recommended concomitant to VA. The aim is to compare clinical and radiological outcomes of VA + SSF versus VA alone. Systematic review, including comparative articles in Kummell’s disease, was performed. This study assessed the following outcome measurements: visual analog scale (VAS), Oswestry Disability Index (ODI), anterior vertebral height (AVH), local kyphotic angle (LKA), operative time, blood loss, length of stay, and cement leakage. Six retrospective studies were included, with 126 patients in the VA + SSF group and 152 in VA alone. Pooled analysis showed the following: VAS, non-significant difference favoring VA + SSF: MD –0.61, 95% CI (–1.44, 0.23), I2 91%, p = 0.15; ODI, non-significant difference favoring VA + SSF: MD –9.85, 95% CI (–19.63, –0.07), I2 96%, p = 0.05; AVH, VA + SSF had a non-significant difference over VA alone: MD –3.21 mm, 95% CI (–7.55, 1.14), I2 92%, p = 0.15; LKA, non-significant difference favoring VA + SSF: MD –0.85°, 95% CI (–5.10, 3.40), I2 95%, p = 0.70. There were higher operative time, blood loss, and hospital length of stay for VA + SSF (p |
| Databáze: | OpenAIRE |
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