Bone cement-augmented vs. conventional pedicle screws for osteoporotic lumbar spondylolisthesis: a meta-analysis
Abstract
Background: In patients with lumbar spondylolisthesis complicated by osteoporosis, conventional pedicle screw internal fixation often leads to complications such as screw loosening and fixation failure due to low bone mineral density. Bone cement-augmented pedicle screw technology has been widely used to enhance screw stability; however, its efficacy and safety in lumbar spondylolisthesis lack systematic evaluation.
Objective: To systematically evaluate the clinical efficacy and safety of bone cement-augmented pedicle screws vs. conventional pedicle screws in the treatment of osteoporotic lumbar spondylolisthesis.
Methods: Relevant literatures were retrieved from databases including PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, and SinoMed from their inception to July 2025. Retrospective cohort studies or randomized controlled trials were included. Two researchers independently screened literatures, extracted data, and assessed the risk of bias. Meta-analysis was performed using RevMan 5.4 software.
Results: A total of 9 studies involving 850 patients were included. Meta-analysis results showed that compared with the conventional screw group, the bone cement-augmented screw group had significantly better outcomes in terms of the last follow-up Visual Analogue Scale (VAS) score (MD = -0.15, 95% CI: -0.22 to -0.08, P P = 0.04), intervertebral space height (MD = 1.99, 95% CI: 0.73-3.25, P = 0.002), screw loosening rate (OR = 0.18, 95% CI: 0.09-0.38, P P…
How strong is the evidence?
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: 850 participants or records.
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