PMID- 28513888 OWN - NLM STAT- MEDLINE DCOM- 20180425 LR - 20220129 IS - 1523-4681 (Electronic) IS - 0884-0431 (Linking) VI - 32 IP - 9 DP - 2017 Sep TI - Pain, Quality of Life, and Safety Outcomes of Kyphoplasty for Vertebral Compression Fractures: Report of a Task Force of the American Society for Bone and Mineral Research. PG - 1935-1944 LID - 10.1002/jbmr.3170 [doi] AB - The relative efficacy and harms of balloon kyphoplasty (BK) for treating vertebral compression fractures (VCF) are uncertain. We searched multiple electronic databases to March 2016 for randomized and quasi-randomized controlled trials comparing BK with control treatment (nonsurgical management [NSM], percutaneous vertebroplasty [PV], KIVA VCF treatment system [Benvenue Medical, Inc., Santa Clara, CA, USA], vertebral body stenting, or other) in adults with VCF. Outcomes included back pain, back disability, quality of life, new VCF, and adverse events (AEs). One reviewer extracted data, a second checked accuracy, and two rated risk of bias (ROB). Mean differences and 95% confidence intervals (CIs) were calculated using inverse-variance models. Risk ratios of new VCF and AE were calculated using Mantel-Haenszel models. Ten unique trials enrolled 1837 participants (age range, 61 to 76 years; 74% female), all rated as having high or uncertain ROB. Versus NSM, BK was associated with greater reductions in pain, back-related disability, and better quality of life (k = 1 trial) that appeared to lessen over time, but were less than minimally clinically important differences. Risk of new VCF at 3 and 12 months was not significantly different (k = 2 trials). Risk of any AE was increased at 1 month (RR = 1.73; 95% CI, 1.36 to 2.21). There were no significant differences between BK and PV in back pain, back disability, quality of life, risk of new VCF, or any AE (k = 1 to 3 trials). Limitations included lack of a BK versus sham comparison, availability of only one RCT of BK versus NSM, and lack of study blinding. Individuals with painful VCF experienced symptomatic improvement compared with baseline with all interventions. The clinical importance of the greater improvements with BK versus NSM is unclear, may be due to placebo effect, and may not counterbalance short-term AE risks. Outcomes appeared similar between BK and other surgical interventions. Well-conducted randomized trials comparing BK with sham would help resolve remaining uncertainty about the relative benefits and harms of BK. (c) 2017 American Society for Bone and Mineral Research. CI - (c) 2017 American Society for Bone and Mineral Research. FAU - Rodriguez, Alexander J AU - Rodriguez AJ AD - Bone and Muscle Health Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia. FAU - Fink, Howard A AU - Fink HA AD - Division of Epidemiology and Community Health, School of Public Health, and Department of Medicine, University of Minnesota, Minneapolis, MN, USA. AD - Geriatric Research Education and Clinical Center, Veterans Affairs Healthcare System, Minneapolis, MN, USA. FAU - Mirigian, Lynn AU - Mirigian L AD - American Society for Bone and Mineral Research (ASBMR), Washington, DC, USA. FAU - Guanabens, Nuria AU - Guanabens N AD - Rheumatology Department, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), University of Barcelona, Barcelona, Spain. FAU - Eastell, Richard AU - Eastell R AD - Academic Unit of Bone Metabolism, Mellanby Centre for Bone Research, Northern General Hospital, University of Sheffield, Sheffield, UK. FAU - Akesson, Kristina AU - Akesson K AD - Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science, University of Lund, Malmo, Sweden. FAU - Bauer, Douglas C AU - Bauer DC AD - School of Medicine, University of California, San Francisco, San Francisco, CA, USA. FAU - Ebeling, Peter R AU - Ebeling PR AD - Bone and Muscle Health Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia. AD - Melbourne Medical School (Western Campus), University of Melbourne, St Albans, Australia. AD - Australian Institute for Musculoskeletal Science, St Albans, Australia. LA - eng GR - MR/K006312/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Meta-Analysis PT - Review DEP - 20170626 PL - England TA - J Bone Miner Res JT - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JID - 8610640 SB - IM MH - Aged MH - Female MH - *Fractures, Compression/physiopathology/surgery MH - Humans MH - *Kyphoplasty MH - Male MH - Middle Aged MH - *Pain/physiopathology/surgery MH - *Quality of Life MH - Societies, Medical MH - *Spinal Fractures/physiopathology/surgery MH - United States OTO - NOTNLM OT - AGING OT - KYPHOPLASTY OT - OSTEOPOROSIS OT - PAIN OT - QUALITY OF LIFE OT - VERTEBRAL COMPRESSION FRACTURE EDAT- 2017/05/18 06:00 MHDA- 2018/04/26 06:00 CRDT- 2017/05/18 06:00 PHST- 2016/12/18 00:00 [received] PHST- 2017/03/16 00:00 [revised] PHST- 2017/03/28 00:00 [accepted] PHST- 2017/05/18 06:00 [pubmed] PHST- 2018/04/26 06:00 [medline] PHST- 2017/05/18 06:00 [entrez] AID - 10.1002/jbmr.3170 [doi] PST - ppublish SO - J Bone Miner Res. 2017 Sep;32(9):1935-1944. doi: 10.1002/jbmr.3170. Epub 2017 Jun 26.