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ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1656134

This article is part of the Research TopicRecent Advances in the Management of Osteoporosis: Prevention, Diagnosis and TreatmentView all 7 articles

Comparing the efficacy of teriparatide and bisphosphonates in osteoporotic patients undergoing thoracolumbar spinal fusion: A meta-analysis

Provisionally accepted
Xinghua  JiXinghua Ji1Jinhui  DuanJinhui Duan1Guoyu  HeGuoyu He1Junjie  WangJunjie Wang2*Zejun  XingZejun Xing1
  • 1Shanxi Bethune Hospital, Taiyuan, China
  • 2Shengjing Hospital of China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

Objectives: This study compared the efficacy of teriparatide and bisphosphonates(BPs) in osteoporotic patients who underwent thoracolumbar spinal fusion through a comprehensive meta-analysis of published data from randomized controlled trials and other types of comparative studies. Methods: Major online databases, including PubMed, EMBASE, Web of Science, and Cochrane Central, were searched for studies on the efficacy of teriparatide and BPs in patients treated with thoracolumbar spinal fusion. Studies that evaluated bone union conditions and other subjective or 2 objective outcomes were included. The publication period ranged from database inception to June 13, 2025. Results: Ultimately, 6 articles with 329 patients were included in this meta-analysis. Compared with BPs, teriparatide had advantages in terms of improving the bone union rate at both the 6-month and 1-year follow-ups and reducing the Oswestry Disability Index (ODI) and leg pain visual analogue scale (VAS) score at the 1-year follow-up. The screw loosening rate, VAS score for low back pain at the 1-year follow-up and ODI score at the 6-month follow-up were not clearly different between the teriparatide and BP groups. Conclusion: In patients undergoing thoracolumbar spinal fusion, compared with BPs, teriparatide clearly promotes bone fusion and improves quality of life, with high safety. However, the small number of studies included in this meta-analysis (six) may have influenced the results in the forest plots.

Keywords: Teriparatide, Bisphosphonate, thoracolumbar spinal fusion, Meta-analysis, Osteoporosis

Received: 29 Jun 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Ji, Duan, He, Wang and Xing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Junjie Wang, piccolovegeta@sina.com

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