Efficacy and Safety of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Vertebroplasty in Osteoporotic Vertebral Compression Fractures
Ting Yan, Xiangyang Wang, Bo Liu, Haiying GuanStudy Design:
Systematic review and meta-analysis.
Objective:
To compare the efficacy and safety of ultrasound-guided versus fluoroscopy-guided PVP in the treatment of OVCFs.
Summary of Background Data:
Fluoroscopy-guided percutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fractures (OVCFs). Nonetheless, the radiation-related risks and the drawbacks of imaging have prompted the investigation of ultrasound-guided PVP.
Methods:
A systematic review and meta-analysis comparing ultrasound-guided and fluoroscopy-guided PVP was conducted. The outcomes included were pain relief, functional improvement, operation duration, radiation dose, cement distribution, and complication rates.
Results:
Ultrasound-guided PVP had comparable pain reduction and functional outcomes to fluoroscopy-guided procedures. Radiation exposure and operation time were significantly reduced in the ultrasound-guided group. The use of real-time visualization of soft tissues improved the accuracy of needle placement and minimized cement leakage. There was no significant difference in complication rates between the groups. Recent comparative studies of advanced fluoroscopy-guided techniques, such as robot-assisted and patient-specific guide-assisted procedures, have resulted in further improvements in procedural efficiency and cement leakage rates, with comparable pain relief and functional outcomes.
Conclusions:
PVP using ultrasound guidance is a safe and effective alternative for fluoroscopy-guided PVP, with lower radiation exposure and better procedural safety. These findings require further trials in large-scale studies to verify them and improve clinical practice.