Comparative efficacy of Chinese patent medicines for pain, disability, and bone density in osteoporotic vertebral compression fractures after percutaneous vertebral augmentation: a network meta-analysis

Abstract Background Osteoporotic vertebral compression fractures (OVCFs) are common in elderly patients, and managing postoperative issues after percutaneous vertebral augmentation remains a significant challenge. Chinese patent medicines are considered beneficial complementary therapies, but optimal regimens need systematic assessment. Objective This study aimed to assess the effectiveness of different Chinese patent medicine regimens in improving visual analog scale scores, Oswestry disability index scores, and bone mineral density in OVCF patients following percutaneous vertebral augmentation. Methods A network meta-analysis was conducted on randomized controlled trials (RCTs) from eight databases and ClinicalTrials.gov (up to December 4, 2024). Bayesian methods were employed for statistical analysis, and the results were expressed as mean differences and standardized mean differences with 95% credible intervals. The GRADE system was used to assess the quality of the evidence. All data analyses were performed using the “gemtc” package and Stata 14.2. Results Thirty-six RCTs (3740 patients) were included, comparing 10 Chinese patent medicines. Jinkui Shenqi pill combined with Western medicine was most effective for pain relief (SUCRA 88.03%) and bone mineral density improvement (SUCRA 80.57%). Xianling Gubao capsule showed the highest SUCRA for disability improvement (70.31%). These therapies do not increase adverse risks compared to Western medicine alone. Conclusion Jinkui Shenqi pill and Xianling Gubao capsule demonstrate promising clinical value, but the results are limited by the quantity and quality of available studies. Further clinical research is needed to explore the potential of these Chinese patent medicines, particularly in the context of head-to-head efficacy comparisons, which are currently lacking. Systematic review registration PROSPERO (CRD42023462041).