BACKGROUND:Percutaneous vertebroplasty with bone cement injection has the advantages of minimal invasion, short time, effectively restoring vertebral body height, preventing further colapse of the vertebral body and obvious analgesic effect, which has became an effective method for the treatment of elderly osteoporotic compression fractures. OBJECTIVE:To observe the therapeutic effect of percutaneous vertebroplasty with bone cement injection on elderly osteoporotic compression fractures. METHODS:Sixty-two patients with osteoporotic thoracolumbar vertebral compression fracture, including 22 males and 40 females, aged 55-92 years, involving 86 vertebrae, were included and subjected to percutaneous vertebroplasty with polymethyl methacrylate bone cement injection under C-arm X-ray fluoroscopy. During the postoperative folow-up of 12 to 36 months, visual analogue scale scores, Cobb angle and Oswestry disability index scores were compared before and after the treatment. RESULTS AND CONCLUSION: At 12 to 36 months after treatment, there were 11 cases of complications, including 7 cases of bone cement leakage, 2 cases of adjacent vertebral fractures, 1 cases of bone cement tailing and 1 case of unsatisfactory pain relief. In the final folow-up, Cobb angle, visual analogue scale scores, Oswestry disability index scores were significantly improved compared with those before treatment (P < 0.05).These results demonstrate that percutaneous vertebroplasty with polymethyl methacrylate bone cement injection in the treatment of elderly osteoporotic compression fractures can not only restore vertebral shape, reduce kyphosis, reconstruct spinal stability, but also significantly reduce the pain caused by fractures and improve the life quality of patients. The curative effects in short and medium term are positive.

Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for resectable stage Ⅰ non-small cell lung cancer (NSCLC).Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library,MEDLINE,EMbase,CBM,CNKI,and VIP.Literature selection,quality evaluation,and data extraction were performed by two inspectors based on the inclusion and exclusion criteria.A meta-analysis was performed on the enrolled studies using RevMan 5.3 software.Results A total of four clinical trials involving 410 patients were included.The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery (RR=1.13,95％ CI=0.66-1.94,P=0.66);there was no significant difference in local control rate between SBRT and surgery (RR=0.71,95％ CI=0.26-1.93,P=0.50);patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery (RR=0.29,95％ CI=0.16-0.53,P=0.000).Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC.However,due to the limitations in this systematic evaluation,the conclusion needs to be further confirmed by large randomized controlled trials.