Efficacy and safety of vertebroplasty versus posterior pedicle screw in treating stage III Kummell's disease without neurological deficits: A systematic review and meta-analysis.

Abstract

ObjectiveThis study aimed to evaluate the efficacy and safety of vertebroplasty versus posterior pedicle screw fixation combined with vertebroplasty in treating stage III Kummell's disease without neurological deficits.MethodA systematic literature search was conducted across six databases. A meta-analysis of prospective and retrospective studies meeting the inclusion criteria was conducted using Review Manager 5.4.1.ResultsEight studies (one prospective, one randomized control trial, and six retrospective) involving 409 patients were included. Vertebroplasty demonstrated advantages over posterior pedicle screw + vertebroplasty in operative time (weighted mean difference: -83.22 min; 95% confidence interval: -97.70 to -68.73; p < 0.05), blood loss (weighted mean difference: -158.65 mL; 95% confidence interval: -219.99 to -97.31; p < 0.05), and hospital stay (weighted mean difference: -5.64 days; 95% confidence interval: -7.36 to -3.92; p < 0.05). No significant differences were observed in Cobb's angle (weighted mean difference: 1.28°; 95% confidence interval: -0.21 to 2.78; p > 0.05), relative anterior vertebral height (weighted mean difference: 2.98%; 95% confidence interval: -4.15 to 10.11; p > 0.05), cement leakage (13.2% vs. 8.5%; odds ratios: 1.67; 95% confidence interval: 0.86-3.24; p > 0.05), or wound infection (0% vs. 4.88%; odds ratios: 0.28; 95% confidence interval: 0.07-1.15; p > 0.05).ConclusionBoth vertebroplasty and posterior pedicle screw + vertebroplasty are effective for treating stage III Kummell's disease without neurological deficits. Vertebroplasty offers superior perioperative outcomes with reduced surgical trauma and hospital stay.PROSPERO registration number: CRD420251031065.