Abstract
Osteoporosis is a worldwide disease and osteoporotic vertebral fractures (OVFs) have a high incidence in the elderly population, mostly involving female sex in the postmenopausal status. They are usually treated conservatively with a bed rest period, pain control with analgesics, bracing, bisphosphonates and early rehabilitation. Nevertheless, this kind of treatment can fail with persistent pain, collapse, pseudoarthrosis, kyphotic deformity and neurologic impairment. Therefore, there is the necessity to identify clinical, radiographic and magnetic resonance parameters that might predict risk of complications and conservative treatment failure of osteoporotic vertebral fractures. According to the literature and our experience, major risk factors are the presence of intravertebral cleft, middle column damage, thoracolumbar involvement, superior endplate fracture, a large bony fragment. In conclusion, shape and level of the fracture are risk factors associated with failure of the conservative treatment and therefore in selected cases a surgical treatment might be considered.