What Factors Contribute to the Poor Prognosis of Conservative Treatment for Osteoporotic Vertebral Compression Fracture (OVCF): A Systematic Review
Abstract
Background: Osteoporotic vertebral compression fracture (OVCF) is a prevalent fragility fracture in older adults, often managed with conservative treatment. However, elderly patients are particularly prone to poor prognoses under conservative management, which warrants early identification. This systematic review aims to summarize the risk factors for poor long-term prognosis in older OVCF patients receiving conservative treatment, facilitating early recognition during initial diagnosis.
Methods: This systematic review followed the PRISMA statement criteria and searched the literature until June 2025. The inclusion criteria were patients with OVCFs who underwent conservative treatment only and had at least three months of follow-up. Poor prognoses include no pain relief, dysfunction, and complications such as collapse, nonunion, and kyphosis deformity. The Newcastle‒Ottawa Scale (NOS) was used to screen for articles with a low risk of bias.
Results: This systematic review included 26 articles that met our inclusion criteria. These articles involved 4319 participants (80.2% female), with an average age of 72.91 years. OVCF patients with advanced age, previous spine fracture and steroid medication uses had a poor prognosis. On X-ray, poor prognoses are associated with thoracolumbar involvement, vertebral instability, middle‒column injury, initial fracture parameters, and specific fracture morphology. Additionally, specific MRI signal changes (such as diffuse low-intensity…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 4,319 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.