A systematic review of unilateral versus bilateral percutaneous vertebroplasty/percutaneous kyphoplasty for osteoporotic vertebral compression fractures

OBJECTIVE: The aim of this study was to compare the unilateral and bilateral approaches in treating osteoporotic vertebral compression fractures. METHODS: Based on the principles and methods of the Cochrane systematic reviews, the records of the Cochrane Library, PubMed, Web of Science, Chinese Bio-medicine database, China Journal Full-text Database, VIP database, and Wanfang database were reviewed until October 2014. The randomized controlled trials on unilateral and bilateral approaches to percutaneous vertebroplasty (PVP)/percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures were included. The risk of bias of included trials was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions Version. The RevMan Software 5.0 was used for meta-analysis. RESULTS: Fifteen randomized controlled trials with a total of 850 patients were included. Risk of bias in the included studies was inevitable. There was no statistically significant difference in visual analog scale, vertebral height, kyphotic angular, and quality of life. The main operative complications were bone cement leakage and adjacent vertebral fracture, without difference between the two groups. CONCLUSIONS: In view of the current evidence, there is insufficient evidence to show any difference between the unilateral and bilateral approaches in both the PVP and PKP treatment in osteoporotic vertebral compression fractures. LEVEL OF EVIDENCE: Level I, Therapeutic study.