The analysis of MSTMOVCF (Multi-segment thoracolumbar mild osteoporotic fractures surgery or conservative treatment) based on ASTLOF (the assessment system of thoracolumbar osteoporotic fracture).

To investigate the issue that conservative or surgical treatment for multi-segmental thoracolumbar mild osteoporotic vertebral compression fracture (MSTMOVCF) by applying the assessment system of thoracolumbar osteoporotic fracture (ASTLOF). A single-center prospective cohort study was designed to enroll elderly patients with MSTMOVCF from June 2013 to June 2016, which were divided into conservative and surgery group. The primary outcomes were Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) score, with secondary outcomes including SF-36 and imaging measures such as height of anterior and middle column, Beck value, complications. A total of 470 patients with MSTMOVCF were enrolled. 193 patients underwent surgery of percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) and 277 patients underwent conservative treatment. The VAS score of operation group was significantly lower than that of conservative group (P < 0.0001, for all). The ODI score of the operation group was significantly lower than that of conservative group (P < 0.0001, for all). The SF-36 score, height of anterior and middle column, Beck value in the operation group were higher than those in conservative group (P < 0.0001, for all) at 1-year follow-up. MSTMOVCF underwent surgery can achieve great short-term clinical results. The patient with the sum of revised ASTLOF scores of multiple injured vertebrae ≥ 5 was recommended for surgery.