SYSTEMATIC REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicRecent Advances in the Management of Osteoporosis: Prevention, Diagnosis and TreatmentView all 18 articles
Bone Cement-Augmented versus Conventional Pedicle Screws for Osteoporotic Lumbar Spondylolisthesis: A Meta-Analysis
Provisionally accepted
- First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
[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 versus 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 < 0.0001), Oswestry Disability Index (ODI) score (MD = -2.36, 95% CI: -3.98 to -0.75, P = 0.04), intervertebral space height (MD = 1.99, 95% CI: 0.73 to 3.25, P = 0.002), screw loosening rate (OR = 0.18, 95% CI: 0.09 to 0.38, P < 0.0001), and intervertebral fusion rate (OR = 3.98, 95% CI: 2.36 to 6.73, P < 0.0001). The operation time in the bone cement-augmented group was longer (MD = 32.13, 95% CI: 14.30 to 49.95, P = 0.0004); however, there were no significant differences in intraoperative blood loss, length of hospital stay, or complication rate between the two groups. Conclusion Bone cement-augmented pedicle screws can significantly improve pain, functional status, intervertebral fusion rate, and screw stability in patients with osteoporotic lumbar spondylolisthesis. Although it prolongs the operation time, it does not increase the risk of intraoperative bleeding or complications, thus holding favorable clinical application value.
Keywords: Lumbar spondylolisthesis, Osteoporosis, Bone cement, Pedicle screw, Meta-analysis
Received: 25 Aug 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Qin, Hu, Liang, Li, Bao, Lin, Wang and Zhong. 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: Yuanming Zhong
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.