Efficacy and Safety of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Vertebroplasty in Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta-Analysis
In brief
Ultrasound-guided vertebroplasty reduces radiation and procedure time with similar pain relief
A systematic review and meta-analysis found that ultrasound-guided vertebroplasty provided pain relief and functional outcomes comparable to fluoroscopy-guided procedures, while reducing radiation exposure and operating time. Real-time soft-tissue imaging also improved needle placement and minimized cement leakage, with no significant difference in complication rates. Larger trials are still needed to confirm these findings and guide practice.
- Journal
- Clinical spine surgery (Q1)
- Published
- 19 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Ting Yan, Xiangyang Wang, Bo Liu, Haiying Guan
- PMID
- 42945131
- DOI
- 10.1097/BSD.0000000000002194
Why clinicians should know about it
- Picked for Spine Surgery (paper of the day, 28 October 2026): Systematic review compares vertebroplasty approaches for osteoporotic fractures
Abstract
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare the efficacy and safety of ultrasound-guided versus fluoroscopy-guided PVP in the treatment of OVCFs. SUMMARY OF BACKGROUND DATA: Fluoroscopy-guided percutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fractures (OVCFs). Nonetheless, the radiation-related risks and the drawbacks of imaging have prompted the investigation of ultrasound-guided PVP. METHODS: A systematic review and meta-analysis comparing ultrasound-guided and fluoroscopy-guided PVP was conducted. The outcomes included were pain relief, functional improvement, operation duration, radiation dose, cement distribution, and complication rates. RESULTS: Ultrasound-guided PVP had comparable pain reduction and functional outcomes to fluoroscopy-guided procedures. Radiation exposure and operation time were significantly reduced in the ultrasound-guided group. The use of real-time visualization of soft tissues improved the accuracy of needle placement and minimized cement leakage. There was no significant difference in complication rates between the groups. Recent comparative studies of advanced fluoroscopy-guided techniques, such as robot-assisted and patient-specific guide-assisted procedures, have resulted in further improvements in procedural efficiency and cement leakage rates, with comparable pain relief and functional outcomes. CONCLUSIONS: PVP using ultrasound guidance is a safe and effective alternative for fluoroscopy-guided PVP, with lower radiation exposure and better procedural safety. These findings require further trials in large-scale studies to verify them and improve clinical practice.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.