Evidence map›Paper›PMID 41528445›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Conservative treatments for non-surgically managed osteoporotic vertebral compression fractures: a network meta-analysis of long-term pain and quality of life.

Wei-Cheng Chao, Yu-Hsi Chen, Jui-Chi Shih, Bill Cheng, Ming-Hsien Hu

Abstract readNetwork Meta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Wei-Cheng Chao *Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, 500, Taiwan (R.O.C.).
Yu-Hsi Chen *Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, 500, Taiwan (R.O.C.).
Jui-Chi ShihSchool of Allied Health, Australian Catholic University, Banyo, QLD, Australia.
Bill ChengGraduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan (R.O.C.).
Ming-Hsien HuDepartment of Orthopedics, Show Chwan Memorial Hospital, Changhua, 500, Taiwan (R.O.C.). d109001704@mail.nchu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

methodsFollowing 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.

resultsTwelve full articles (n = 1512) met the inclusion criteria. Teriparatide demonstrated the greatest effect on pain reduction (SMD: - 1.75; 95% CI: - 3.10 to - 0.39) and QoL improvement (SMD: + 3.90; 95% CI: 2.33 to 5.47). Denosumab showed moderate QoL benefit (SMD: + 3.47), while other interventions yielded smaller or non-significant effects.

conclusionTeriparatide is the most effective non-surgical intervention for long-term pain and QoL outcomes in OVCF patients. These findings support a personalized approach to conservative care and underscore the need for high-quality trials with standardized protocols and functional endpoints.

Indexed as

Conservative TreatmentFractures, CompressionOsteoporotic FracturesQuality of LifeSpinal FracturesBone Density Conservation AgentsHumansPain ManagementTeriparatideTreatment OutcomeBone Density Conservation AgentsTeriparatideConservative interventionsNetwork meta-analysisNon-surgical interventionsOsteoporotic vertebral compression fracturesOVCFsQuality of lifeTeriparatide

Identifiers

PMID41528445
PMCPMC13083475

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.