title: Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures: A meta-analysis.
abstract: OBJECTIVE
  Although the majority of available evidence suggests that vertebroplasty and kyphoplasty can relieve pain associated with vertebral compression fractures (VCFs) and improve function, some studies have suggested results are similar to those of placebo. The purpose of this meta-analysis was to compare the outcomes of vertebroplasty and kyphoplasty with conservative treatment in patients with osteoporotic VCFs.
  
  
  METHODS
  Medline, Cochrane, and Embase databases were searched until January 31, 2015 using the keywords: vertebroplasty, kyphoplasty, compression fracture, osteoporotic, and osteoporosis. Inclusion criteria were randomized controlled trials (RCTs) in which patients with osteoporosis, and VCFs were treated with vertebroplasty/kyphoplasty or conservative management. Outcome measures were pain, function, and quality of life. Standardized differences in means were calculated as a measure of effect size.
  
  
  RESULTS
  Ten RCTs were included. The total number of patients in the treatment and control groups was 626 and 628, respectively, the mean patient age ranged from 64 to 80 years, and the majority was female. Vertebroplasty/kyphoplasty was associated with greater pain relief (pooled standardized difference in means = 0.82, 95% confidence interval [CI]: 0.374-1.266, P < 0.001) and a significant improvement in daily function (pooled standardized difference in means = 1.273, 95% CI: 1.028-1.518, P < 0.001) as compared with conservative treatment. The pooled estimate indicated vertebroplasty/kyphoplasty was associated with higher quality of life (pooled standardized difference in means = 1.545, 95% CI: 1.293-1.798, P < 0.001). Subgroup analysis of 8 vertebroplasty studies and 2 kyphoplasty studies that reported pain data, however, indicated that vertebroplasty provided greater pain relief than conservative treatment but kyphoplasty did not.
  
  
  CONCLUSIONS
  Vertebroplasty may provide better pain relief than balloon kyphoplasty in patients with osteoporotic VCFs, both may improve function, and their effect on quality of life is less clear.
authors: Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital) School of Medicine, National Yang Ming University Department of Radiology, Taipei Veterans General Hospital Medical Imaging Department, Taipei Beitou Health Management Hospital Department of Neurology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan, ROC.
authors: Wei-Hsin
authors: WH
authors: Yuan
authors: Hui-Chen
authors: HC
authors: Hsu
authors: Kaun-Lin
authors: KL
authors: Lai
mesh_terms: D000072700:Conservative Treatment; D050815:Fractures, Compression / Q000628:therapy*; D006801:Humans; D058498:Kyphoplasty; D058866:Osteoporotic Fractures / Q000628:therapy*; D059408:Pain Management; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016103:Spinal Fractures / Q000628:therapy*; D054854:Vertebroplasty; D064232:Visual Analog Scale