I. Overview Osteoporosis is a health problem with well-defined pathophysiological, psychosocial and economic consequences. A serious consequence of osteoporosis is the occurrence of osteoporotic fractures, which are fractures that can occur with minor trauma or during daily activities due to decreased bone strength. Osteoporosis greatly increases disability and mortality in the elderly. Pain, spinal deformity and the occurrence of fragility fractures are the most typical clinical manifestations of osteoporosis. Patients often present with low back pain or peripheral pain, increased pain or restricted movement with increased load, and in severe cases, difficulty in turning over, sitting up and walking. Possible mechanisms of lower back pain caused by osteoporosis: 1) destruction of vertebral trabeculae and stimulation of bone sensory nerves; 2) decrease in bone strength due to osteoporosis, which can lead to vertebral compression fractures under minor trauma, thus causing pain; 3) decrease in weight-bearing capacity of patients with osteoporosis, with kyphosis deformity of the spine and high tension of the lumbar back muscles for a long time, resulting in muscle and myofascial low back pain. Prevention Once osteoporotic fractures occur, the quality of life decreases and various complications occur, which can be disabling or fatal, so prevention of osteoporosis is more realistic and important than treatment. Besides, osteoporosis can be prevented. Primary prevention of osteoporosis is aimed at those who have not had fractures but have risk factors for osteoporosis, or those who already have reduced bone mass and should be prevented from developing osteoporosis. The ultimate goal of prevention is to prevent the first fracture from occurring. Secondary prevention and treatment of osteoporosis refers to those who already have osteoporosis or have had a fracture, and the ultimate goal of their prevention and treatment is to avoid the first fracture and re-fracture. Prevention strategies for osteoporosis include: 1. Lifestyle modification (1) A balanced diet rich in calcium, low in salt and moderate in protein. (2) Adequate outdoor activities, physical exercise and rehabilitation that contribute to bone health. (3) Avoid smoking, alcohol abuse and caution in the use of drugs that affect bone metabolism. (4) Take various measures to prevent falls: for example, pay attention to the presence of diseases and drugs that increase the risk of falls, and strengthen protective measures for oneself and the environment, etc. 2, bone health basic supplements (1) calcium: China’s nutrition society set the recommended daily calcium intake of adults 800mg (elemental calcium), is the ideal bone peak to maintain bone health, if the supply of calcium in the diet is not enough to choose calcium supplements, postmenopausal women and the elderly daily calcium intake recommended amount of 1000mg, China’s average daily calcium from the diet of the elderly about 400 mg Therefore, the average daily amount of elemental calcium should be 500-600mg. (2) Vitamin D: It is beneficial to the absorption of calcium in the gastrointestinal tract. The recommended dose for adults is 200 units/d. For elderly people, the recommended dose is 400-800 units/d due to lack of sunlight and impaired intake and absorption of vitamin D. Treatment 1. Medication Indications for medication: osteoporosis or fragility fracture; or bone loss with risk factors of osteoporosis. 2.Surgical treatment As the elderly population increases, the number of patients with osteoporotic vertebral fractures gradually increases, therefore, osteoporotic vertebral fractures are receiving increasing attention. Percutaneous vertebroplasty (PVP) is a new minimally invasive treatment technique for the spine that has emerged in recent years and is a major advance in the treatment of osteoporotic vertebral fractures. First reported by Galibert et al. in 1987, percutaneous vertebroplasty was used for the treatment of vertebral hemangiomas. This technique provides rapid pain relief and minimal trauma, and is a new and effective minimally invasive method for the treatment of osteoporotic vertebral compression fractures in particular. By filling the vertebral body with reinforcing material through percutaneous puncture, the fracture can be stabilized, the mechanical strength of the vertebral body can be restored, further collapse of the vertebral body can be prevented and pain can be relieved, enabling the patient to resume normal activities early. Osteoporosis leads to a reduction in vertebral mechanical strength and causes vertebral compression fracture (VCF), with a 20% incidence of VCF in people over 70 years of age, and a 20% or 4 mm reduction in vertebral body height is considered a VCF. fractures, with wedge compression fractures being the most common (51%). Osteoporotic vertebral fractures can lead to low back pain, kyphosis and reduced mobility, which affects patients’ respiratory and digestive functions and reduces their quality of life. Traditional treatment methods such as bed rest, brace protection, oral pain medication and incisional surgery are often less than ideal. Surgical treatment is limited by the difficulty of internal fixation and poor fusion, and patients with osteoporotic vertebral fractures have a 5-25-fold increased risk of recurrent vertebral fractures in adjacent vertebrae within 1 year.