Comparison of Outcomes Between Percutaneous Vertebroplasty and Percutaneous Kyphoplasty for the Treatment of Kümmell's Disease: A Meta-Analysis.

STUDY DESIGN A meta-analysis. OBJECTIVE The aim is to compare the efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating Kummell's disease (KD) without neurological deficits. SUMMARY OF BACKGROUND DATA PVP and PKP are routine methods for the treatment of KD without neurological deficits; however, whether PVP or PKP is superior is a matter of debate. MATERIALS AND METHODS According to the Cochrane Handbook for Systematic Reviews of Interventions, PubMed, Embase, the Cochrane Library, and Web of Knowledge were searched for eligible randomized controlled trials or cohort studies. Two authors independently collected data and assessed the methodologic quality of the included studies. Intraoperative and postoperative clinical outcomes, cement leakage, refracture rate, and the costs during hospitalization were evaluated. RESULTS Five observational studies comparing 119 PVP and 128 PKP patients were included in qualitative and quantitative reviews. All of the included s studies had evidence of good quality, as assessed by the Newcastle-Ottawa scale. On the basis of meta-analysis the operation time [weighted mean difference: -10.65; 95% confidence interval (95% CI): -11.94 to -9.35; P<0.00001] and hospitalization cost (weighted mean difference: -2.38; 95% CI: -2.87 to -1.89; P<0.00001) were less for PVP, while the cement leakage rate was lower for PKP (odds ratio: 3.03; 95% CI: 1.58-5.82; P<0.001). Together, the data indicated that the differences in cement volume, visual analog scale score, Oswestry disability index score, Cobb angle, anterior vertebral height, and refracture rate were not significantly different. CONCLUSION The findings of this study suggest that PVP and PKP are safe and effective for the treatment of KD. PVP required less operative time and was more affordable, but PKP was superior given the lower cement leakage rate. Additional high-quality randomized controlled trials designed to support these findings are warranted.