Abstract
OBJECTIVE: To systematically evaluate the effects of vertebroplasty (VP) and kyphoplasty (KP) on pain and spinal imaging parameters in patients with osteoporotic vertebral compression fractures (OVCF). METHODS: A comprehensive search of eight databases was conducted from inception to November 2024 to identify randomised controlled trials (RCTs) published in Chinese and English. Eligible studies included clinical RCTs comparing KP and VP in patients with OVCF, assessing vertebral pain and imaging parameters. Risk of bias and methodological quality were assessed using the Cochrane Appraisal Tool. Combined effects were calculated using a random effects model. Heterogeneity was assessed using the I(2) test. RESULTS: A total of 16 randomised controlled trials involving 1738 patients were included. The analysis revealed no statistically significant difference between KP and VP in pain reduction (SMD = 0.08, 95% CI = -0.04 to 0.20, P = 0. 19) or spinal function (SMD = 0.04, 95% CI = -0.11 to -0.19, P = 0. 62). However, KP demonstrated significantly better outcomes than VP in vertebral compression rate (SMD = 1.39, 95% CI = 0.81 to 1.96, P < 0. 00001), Cobb angle (SMD = 1.83, 95% CI = 0.99 to 2.68, P < 0. 0001) and the incidence of cement leakage (OR = 1.92, 95% CI = 1.41 to 2.62, P < 0. 0001). CONCLUSION: Our results suggest that KP is more effective than VP in improving postoperative vertebral compression rate and Cobb angle, and reducing the incidence of cement leakage.