Unilateral Versus Bilateral Percutaneous Kyphoplasty for Single-Level Thoracolumbar Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta-Analysis
Abstract
Background/Objectives: The optimal surgical approach for Percutaneous KyphoPlasty (PKP) in patients with recent single-level Osteoporotic Vertebral Compression Fractures (OVCFs) remains controversial. Most available previous meta-analyses included studies with variable heterogeneity, often mixing unilateral and bilateral MIS approaches, differing surgical techniques, and various fracture patterns, which limited the reliability of their conclusions. This meta-analysis aimed to compare the efficacy and safety of unilateral versus bilateral PKP exclusively in patients with recent single-level OVCFs only. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, Scopus, Cochrane Library, and ScienceDirect were searched for comparative studies published between 2000 and 2025. Randomized Controlled Trials (RCTs), prospective, and retrospective comparative studies comparing unilateral and bilateral PKP for recent single-level OVCFs were included. Clinical and radiological outcomes as well as perioperative complications and safety outcomes were analyzed using random-effects meta-analysis. Predefined subgroup analyses according to study design and sensitivity analyses were performed. Results: Eleven studies involving 1374 patients (705 unilateral and 669 bilateral PKP) met the inclusion criteria. No significant differences were observed between the two surgical approaches regarding short- or long-term pain relief, cement leakage, number of adjacent…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,374 participants or records.
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