With the advent of an aging society, crestal fractures due to osteoporosis are becoming more common in the elderly. Fractures caused by osteoporosis are mostly seen in the thoracolumbar segment, and there are more elderly women than elderly men. After a vertebral fracture, severe pain occurs locally in the fracture, which is aggravated by sitting, standing and moving down. Patients and their families are in great pain and do not know what to do, so what should be done for vertebral osteoporotic compression fractures in the elderly? First, we need to briefly understand what is osteoporosis. Osteoporosis is an insidious pathological state that gradually appears with doing age gain and bone loss. Not only does it show a decrease in bone quality, but it is also accompanied by changes in bone trabecular structure. If a house had 10 pillars, but now it has only 3 pillars, the house is more likely to collapse than before. This is shown in the figure below. So how do you treat osteoporotic compression fractures in the vertebrae? Treatment is divided into conservative treatment and surgical treatment. Conservative treatment is absolute bed rest, generally need to bed rest for 3 months, after bed rest, the fractured vertebrae do not bear the weight, can facilitate the healing of the fractured vertebrae. Patients can lie flat or on their sides, but they cannot sit up or stand up, including urinating and defecating in bed, and they cannot lie in bed with the head of the bed raised. The patient’s bed should not be too soft or too hard. If the fracture compression is more serious, a thin pillow should be placed on the back of the fracture when lying down to help reset the fracture. The elderly are prone to bedridden complications, such as lung infections and venous thrombosis of the lower limbs. Then there are several points to note: 1. when lying down, strengthen the activities of both lower limbs and perform muscle contraction, you can perform straight leg raising exercises; 2. drink more water to prevent urinary stones and urinary tract infections; 3. turn over more often and prevent lung infections. Conservative treatment can eliminate the risk of surgery and the cost of treatment is relatively low. However, it requires a long period of strict bed rest, affecting the quality of life, and there are more bed rest complications in the elderly, which many patients find difficult to tolerate, so surgery is also a good choice. Surgical treatment of osteoporotic compression fractures of the vertebral body is a very mature technique with largely manageable surgical risks and a short operative time (about 30 minutes for one segment). It is essentially a percutaneous puncture to establish a working channel to restore the height of the fractured vertebral body and inject bone cement into the fractured vertebral body, thereby restoring the height and strength of the fractured vertebral body and achieving an immediate pain relief effect. This is shown in the figure below. Thoracic 12 vertebral compression fracture bone cement is well positioned and the vertebral body height is well repositioned Half an hour of surgery, bleeding 5 ml, two incisions add up to about 6 mm, next day back to normal life Vertebral osteoporosis compression fracture, its root is osteoporosis, so regardless of conservative treatment or surgery, it is necessary to carry out systematic, long-term, regular anti-osteoporosis treatment. A healthy diet, reasonable exercise, and necessary medication are all effective measures to prevent vertebral osteoporotic fractures.