BACKGROUND:Percutaneous kyphoplasty is an effective treatment for osteoporotic compression fractures, but randomized controled trials have smal sample size and methodological shortcomings. The priority of unilateral approach or bilateral approach of percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures is stil controversial. OBJECTIVE:To comprehensively evaluate and compare the unilateral and bilateral percutaneous kyphoplasty, and provide evidence for the selection of surgical approach. METHODS:A computer-based online search was done in the English and Chinese databases such as Cochrane Library, PubMed, OVID, Embase, China Biology Medicine disc, Wanfang, and VIP. Nine relevant Chinese orthopedic journals were manualy searched from the initial issue to the issue published in March 2014. Randomized controled trials comparing unilateral and bilateral kyphoplasty for osteoporotic vertebral compression n fractures were colected. According to the inclusion and exclusion criteria, two evaluators performed the selection of test, data extraction and quality assessment. RevMan 5.2 software was used for meta-analysis. RESULTS AND CONCLUSION: Eight randomized controled trials involving 507 patients and 656 vertebral bodies were involved in the result analysis. The results showed that, there was no bone cement leakage between the two groups; preoperative visual analog scale score (WMD=-0.05,P=0.58) at short-term folow-up (≤ 3 months) (WMD=-0.02, P=0.25) and long-term folow-up (≥ 12 months) (WMD=0.08,P=0.64) also showed no significant differences between the two groups. Oswestry disability index at short-term folow-up (WMD=0.13,P= 0.73) and long-term folow-up (WMD=0.05,P= 0.98) in the two groups had no statistical significance. This meta-analysis showed significant difference in the bone cement volume and operating time, and the unilateral approach was better than bilateral approach. Radiographic findings showed that preoperative and postoperative kyphosis angle and restoration rate were not statisticaly different between the two groups. This meta-analysis comparing unilateral and bilateral percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures demonstrates no significant differences regarding the visual analog scale scores, radiographic outcomes and complications. Considering the operation time and radiation exposure, we recommend unilateral percutaneous kyphoplasty.%背景：经皮球囊灌注骨水泥椎体成形已被证实对骨质疏松性压缩骨折有效，但相关的随机对照试验存在样本量小和方法学上的缺陷，因此单侧入路或者双侧入路椎体后凸成形修复骨质疏松性压缩骨折孰优孰劣，仍存在争议。目的：使用系统评价的方法对经皮球囊灌注骨水泥椎体成形单侧入路与双侧入路方法进行分析，以期为椎体后凸成形入路及灌注骨水泥过程中的技术选择提供依据。方法：计算机检索Cochrane Library、PubMed、OVID、Embase、中国生物医学文献数据库、万方数据库、维普资讯等中英文数据库，手工检索9种国内相关杂志，检索日期均从创刊至2014年3月，收集单侧与双侧入路经皮球囊灌注骨水泥椎体后凸成形修复骨质疏松性椎体压缩骨折的随机对照试验，由2名系统评价员按纳入与排除标准选择试验、提取资料和质量评价后，并用RevMan 5.2软件进行Meta分析。结果与结论：最终纳入8个随机对照试验，共507例患者656个椎体。结果显示，骨水泥渗漏方面两组差异无显著性意义；术前目测类比评分[WMD=-0.05(P=0.58)]、短期随访(≤3个月)[WMD=-0.02(P=0.25)]与长期随访(≥12个月)[WMD=-0.08(P=0.64)]，两组差异无显著性意义；Oswestry功能障碍指数(ODI)短期随访[WMD=-0.13(P=0.73)]和长期随访[WMD=-0.26(P=0.81)]，两组差异无显著性意义；骨水泥用量和操作时间两组差异有显著性意义，单侧入路较双侧入路有优势；影像学结果中术前、术后后凸角及角度恢复值，差异均无显著性意义提示单侧和双侧入路经皮球囊灌注骨水泥椎体后凸成形修复骨质疏松性椎体压缩骨折，在目测类比评分、影像学结果、并发症方面无明显差异；但在手术时间和放射暴露时间上，单侧入路优于双侧入路。
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