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. 2018 Nov 6;2018(11):CD006349. doi: 10.1002/14651858.CD006349.pub4

Liu 2010.

Methods Design: single‐centre, two‐arm, randomised controlled trial
Setting: Taichung, Taiwan
Timing: not stated
Interventions: percutaneous vertebroplasty versus kyphoplasty
Sample size:a priori sample size calculation not reported
Analysis: not reported
Participants Number of participants
  • Number screened not reported

  • 100 participants randomised (50 in each group)

  • Loss to follow‐up not explicitly reported

  • Data may have been available for all participants at the final 6‐month follow‐up


Inclusion criteria
  • Confirmed osteoporotic vertebral compression fracture at the thoraco‐lumbar junction (T12‐L1)


Exclusion criteria
  • None reported


Baseline characteristics
Vertebroplasty Group
Mean (SD) age: 74.3 (6.4) years; 38 female, 12 male
Mean (SD) duration between 'injury' and treatment: 15.8 (6.7) days
Location: 12 T12, 38 L1
Mean (SD) pain at baseline: 7.9 (0.7)
Kyphoplasty group
Mean (SD) age: 72.3 (7.6) years; 39 female, 11 male
Mean (SD) duration between 'injury' and treatment: 17.0 (7.7) days
Location: 11 T12, 39 L1
Mean (SD) pain at baseline: 8.0 (0.8)
Interventions Percutaneous vertebroplasty
The surgical procedures involved IV general anaesthesia (Propofol) and 2% xylocaine injected locally. A special bone biopsy needle (Angiotech, USA) was passed percutaneously and slowly through each side of the pedicle into the vertebral body. The bone filler PMMA (Zimmer) was prepared and mixed with both gentamicin, to reduce risk of infection, and powder containing barium, allowing X‐ray visualisation. An optimal amount of bone filler was injected into the vertebral body via the needles on both sides. All procedures were performed under a mobile C‐arm X‐ray.
Balloon kyphoplasty
The same anaesthesia was employed. Using image guidance, two small incisions were made, a probe was placed into the vertebral space at the fracture site. The bone was drilled and a balloon (VCF‐X CentralMedical Tech., Taiwan), called a bone tamp, was inserted on each side. The balloons were then inflated with contrast medium (to facilitate image guidance X‐rays) and expanded to the desired height and removed. The spaces created by the balloons were then filled with PMMA (prepared as for vertebroplasty) to bind the fracture.
Follow‐up
All participants undertook an orally administered treatment regimen to protect their bone density after surgery (details not reported).
Outcomes Outcomes were reported at baseline, 3 days, 6 months, 1, 2 and 5 years.
Primary outcomes
  • Measurement of vertebral body height

  • Measurement of kyphotic wedge angle (to evaluate kyphosis)

  • Pain, measured on a 10‐point VAS


Outcomes included in this review
  • Mean pain

Source of funding Grant from Chung‐Shan Medical University Hospital (CS08110).
Notes Trial registration: not found.
We extracted outcomes at 6 months, 1 and 2 years.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomly assigned according to permuted block randomisation which was likely to be adequate.
Allocation concealment (selection bias) Unclear risk Whether or not treatment allocation was concealed is not reported.
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Whether or not participants and investigators were blinded to treatment allocation is not reported.
Blinding of outcome assessment (detection bias) 
 Self‐reported outcomes (e.g., pain, disability) Unclear risk Whether or not participants were blinded to treatment allocation is not reported.
Blinding of outcome assessment (detection bias) 
 Objective outcomes (e.g., radiographic outcomes) Unclear risk Quote: "Radiographic measurement was made by technicians 'blind' to treatment group status, with variability controlled via inter‐ and intra‐observer comparisons". No details of the inter‐ and intra‐observer comparisons are reported.
Incomplete outcome data (attrition bias) 
 All outcomes Unclear risk Completeness of follow‐up was not explicitly reported.
Selective reporting (reporting bias) Unclear risk Trial not registered and trial protocol was not published. All outcomes listed in the methods are reported.
Other bias Low risk None apparent.