Effectiveness of Teriparatide for spine fusion in osteoporotic patient: A systematic Review and Meta-Analysis of comparative studies

Our goal was to assess Teriparatide's effectiveness in improving radiographic and functional outcomes after spinal fusion surgery. This meta-analysis included randomized controlled trials (RCTs) and comparative cohort studies. The findings provide valuable insights and guidance for surgeons treating osteoporotic patients undergoing spinal fusion surgery. We conducted a systematic review to assess Teriparatide's efficacy in spinal fusion surgery for osteoporosis. Through thorough selection, data extraction, and quality assessment, we employed network meta-analysis to evaluate radiographic outcomes (fusion rate, screw loosening, vertebral fracture) and changes in bone density (BMD) measured by Hounsfield units (HU). Functional outcomes were assessed using the Oswestry Disability Index (ODI) scales. Our study aims to comprehensively understand Teriparatide's impact and effectiveness in spinal fusion surgery. A total of 868 patients were included in the analysis. All patients underwent thoracolumbar internal fixation fusion surgery and were divided into two groups: the Teriparatide treatment group and the control group. The results revealed significant differences in radiological outcomes. The fusion rate showed a significant difference, as well as screw loosening, and BMD measured in Hounsfield units. However, there was no significant difference in vertebral fracture. The Teriparatide group demonstrated favorable effects with statistical significance. In terms of functional outcomes, there was no significant difference in the assessment of ODI scores between the two treatment groups. The meta-analysis demonstrated that the Teriparatide group exhibited significantly better outcomes, particularly in radiological measures, when compared to the control group. The use of Teriparatide in spinal fusion surgery shows promise in reducing postoperative complications and providing overall benefits.