Different Acupuncture Therapies for Postoperative Residual Pain Following PKP/PVP for Osteoporotic Vertebral Compression Fractures: A Protocol for a Systematic Review and Bayesian Network Meta-Analysis.

BACKGROUND

Osteoporotic Vertebral compression fracture (OVCF) is a common consequence of osteoporosis and accounts for a substantial proportion of osteoporotic fractures. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are among the common treatment modalities for OVCF. In patients undergoing PVP/PKP, approximately one quarter experience postoperative residual pain, which seriously affects the health and quality of life of patients. Acupuncture has exhibited promising efficacy in alleviating residual pain after PKP/PVP; still some controversy remains. Clinical researches have demonstrated the effectiveness of acupuncture; however it is still unclear which acupuncture technique is best for relieving pain in patients who have had PKP/PVP. A Bayesian network meta-analysis (NMA) will be used to examine the relative effectiveness of several acupuncture modalities in postoperative OVCF patients.

METHODS

The search strategy covers PubMed, Cochrane Library, Web of Science, Embase, Wanfang Database, VIP Database, and China National Knowledge Infrastructure (CNKI) from database inception to March 15, 2026, with language restrictions applied to English or Chinese publications. Pain intensity serves as the primary outcome. Secondary outcomes include the Oswestry Disability Index (ODI), serum procollagen type I N-terminal propeptide, serum beta-C-terminal telopeptide of type I collagen, and adverse events. A Bayesian NMA will be performed using MetaInsight and Stata 14. The protocol for this review has been registered with PROSPERO (No. CRD420261336974) on March 10, 2026.

RESULTS

This Bayesian network meta-analysis will generate relative effect estimates for each acupuncture modality. The interventions will be ranked by the surface under the cumulative ranking curve (SUCRA), and the certainty of evidence for each outcome will be graded using the CINeMA framework.

CONCLUSION

Our findings are expected to provide guidance for residual pain management after PKP/PVP. This could help reduce the risk of analgesic‑related side effects and ultimately improve patients' quality of life.