Comparison of PMMA Bone Cement Dosage Used in Vertebroplasty and Balloon Kyphoplasty: A Meta-analysis of Data from Randomized Controlled Trials

Abstract

Background and Aim: Vertebroplasty (VP) and balloon kyphoplsty (BKP) are widely used to treat patients in whom the pain, arising from vertebral body fracture(s), is refractory to conservative treatment(s). Currently, poly(methyl methacrylate) (PMMA) bone cement is the cement of choice in VP and BKP. The relationship between the volume of the PMMA bone cement used (“PMMA bone cement dosage”) and cement extravasation, a common complication in both procedures, has not been established. The purpose of the present study was to conduct a meta-analysis in order to determine the statistical nature of the difference in cement dosage used in these two procedures. Methods: Computerized and manual searches of the literature on VP and BKP were conducted to identify relevant articles in the open literature. These articles were scrutinized against a set of exclusion and inclusion criteria, such as type of study (for example, randomized controlled trial (RCT) and case series), for acceptance for use in the meta-analysis. Results: The final dataset were taken from 6 articles. A larger cement dosage was used in VP than in BKP but the difference is not significant; for example, with a random-effects model, odds ratio = 2.883; 95%CI = 0.419, 19.845; Z = 1.076; p = 0.282. Conclusion: The difference in cement dosage used in VP and that used in BKP is not significant.