Conservative treatments for non-surgically managed osteoporotic vertebral compression fractures: a network meta-analysis of long-term pain and quality of life
Abstract
The aim of this systematic review and network meta-analysis was to evaluate and rank the long-term effectiveness of conservative interventions for osteoporotic vertebral compression fractures (OVCFs). Teriparatide demonstrated the greatest efficacy for both pain relief and quality of life improvement, significantly outperforming other non-surgical options. These results highlight the superior benefit of specific pharmacological therapies over other conservative strategies for long-term patient outcomes.
Purpose: Osteoporotic vertebral compression fractures (OVCFs) are a major cause of pain, disability, and poor quality of life (QoL) in the elderly population. Although non-surgical interventions are widely used, long-term comparative evidence remains limited. This study aimed to conduct a systematic review and network meta-analysis (NMA) to evaluate and rank the long-term (≥ 6 months) effectiveness of conservative interventions for OVCFs in terms of pain relief and QoL improvement.
Methods: Following PRISMA-NMA guidelines, five databases were searched for randomized controlled trials involving adults (≥ 50 years) with radiographically confirmed OVCFs. Interventions included pharmacologic therapies (e.g., teriparatide, denosumab), exercise, manual therapy, and combination strategies. Outcomes were standardized across studies and analyzed using a frequentist random-effects model.
Results: Twelve full articles (n = 1512) met the inclusion criteria. Teriparatide demonstrated the…
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: 1,512 participants or records.
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