通过Meta分析，评估椎体成形术联合抗骨质疏松药物治疗中老年骨质疏松性椎体压缩骨折的临床疗效。

根据人群、干预、比较、结果及研究设计(PICOS)原则制定检索策略，在Cochrane数据库、PubMed、荷兰医学文摘（Embase）、中国知网（CNKI）、万方、维普、中国生物医学文献数据库（CBM）中检索有关椎体成形术联合抗骨质疏松药物治疗中老年骨质疏松性椎体压缩骨折的随机对照试验，检索文献的时间范围限定在2015年1月至2025年1月，并将Meta分析、综述、非随机对照试验研究及动物实验等文献剔除。在评估文献质量，并提取治疗效果、疼痛视觉模拟评分（VAS）、骨密度（BMD）、Barthel指数评分及Oswestry功能障碍指数等结局指标后，运用Revman 5.3及stata15.0软件进行统计分析，采用固定效应或随机效应模型，评估异质性。

本次Meta分析最终一共纳入11篇随机对照研究，包括953例患者。其中实验组481例，对照组472例。Meta分析结果表明：相比于单纯椎体成形术治疗组，椎体成形术联合抗骨质疏松药物治疗组VAS评分更低[均数差（MD）=-1.37，95%置信区间(CI)（-1.42，-1.32），P<0.05]；BMD更高[MD=0.20，95%CI（0.17，0.23），P<0.05]；治疗效果更好[比值比（OR）=2.45，95%CI（1.41，4.24），P<0.05]；Barthel指数评分更高[MD=18.44，95%CI（16.72，20.15），P<0.05]；Oswestry功能障碍指数更低[MD=-8.38，95%CI（-9.15，-7.61），P<0.05]。

针对临床上的中老年骨质疏松性椎体压缩骨折患者，椎体成形术联合抗骨质疏松药物这一治疗方案相较于单纯应用椎体成形术治疗，VAS评分明显降低，BMD显著提高，治疗效果更好，Barthel指数评分更高，Oswestry功能障碍指数更低，提示联合治疗可作为中老年OVCF患者的优选方案，但需结合个体化抗骨质疏松药物选择，建议推广椎体成形术联合抗骨质疏松药物这一治疗方案治疗中老年骨质疏松性椎体压缩骨折患者。

To evaluate the clinical efficacy of vertebroplasty combined with anti-osteoporosis drugs in the treatment of osteoporotic vertebral compression fractures in the middle-aged and elderly by meta-analysis.

According to the population, intervention, comparison, outcome and study design (PICOS) principle, the search strategy is formulated and implemented. Cochrane Library PubMed, Excerpta Medica Database (Embase), China National Knowledge Infrastructure (CNKI), Wanfang database, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM) were searched for randomized controlled trials of vertebroplasty combined with anti osteoporotic drugs in the treatment of osteoporotic vertebral compression fractures in middle-aged and elderly patients. The time range of literature search was limited from January 2015 to January 2025, and meta-analysis, review, non randomized controlled trial research and animal experiments were removed. After evaluating the quality of the literature, and extracting the treatment outcome, visual analogue scale (VAS), bone mineral density (BMD), Barthel index score, Oswestry dysfunction index and other outcome indicators, Revman 5.3 and Stata 15.0 software were used for statistical analysis, and fixed effect or random effect models were used to evaluate the heterogeneity.

A total of 11 randomized controlled studies were included in this meta-analysis, including 953 patients, including 481 cases in the experimental group and 472 cases in the control group. The results of meta-analysis showed that the VAS score of vertebroplasty combined with drug therapy for osteoporosis group was lower than that of vertebroplasty alone group [mean difference (MD)=-1.37, 95%confidence interval (CI) (-1.42, -1.32), P<0.05]. BMD was higher in the vertebroplasty combined with drug therapy for osteoporosis group [MD=0.20, 95% CI (0.17, 0.23), P<0.05]. The treatment outcome of vertebroplasty combined with drug therapy for osteoporosis group was better [odds ratio (OR)=2.45, 95% CI (1.41, 4.24), P<0.05]. The Barthel index score was higher in the vertebroplasty combined with drug-therapy-for-osteoporosis group [MD=18.44, 95% CI (16.72, 20.15), P<0.05]. The Oswestry dysfunction index was lower in the vertebroplasty combined with drug therapy for osteoporosis group [MD=-8.38, 95% CI (-9.15, -7.61), P<0.05].

For middle-aged and elderly patients with osteoporotic fractures with vertebral crush injuries, vertebroplasty combined with drug therapy for osteoporosis, compared with vertebroplasty alone, has significantly reduced visual analog score, significantly improved bone mineral density, better treatment outcome, higher Barthel index score, and lower Oswestry dysfunction index. It is suggested that vertebroplasty combined with drug therapy for osteoporosis, should be promoted in the treatment of middle-aged and elderly patients with osteoporotic fractures with vertebral crush injuries.