The Osteoporotic Vertebral Fracture Conservative Treatment Prognosis Score (OVF-CTPS)

STUDY DESIGN: A prospective cohort study (Level III). OBJECTIVE: To develop and validate a clinical scoring system (Osteoporotic Vertebral Fracture Conservative Treatment Prognosis Score, OVF-CTPS) for predicting the prognosis of conservative treatment in patients with osteoporotic vertebral fractures (OVFs), addressing clinical uncertainty in treatment selection. SUMMARY OF BACKGROUND DATA: OVFs face uncertainty in choosing conservative versus surgical management. Ten percent to 40% of patients have conservative treatment failure ( e.g. , nonunion, collapse). Existing classification systems lack prognostic value, highlighting the need for a practical predictive tool. METHODS: Two hundred one patients with acute OVFs undergoing conservative treatment were prospectively followed for 6 months. Baseline assessments included demographics, pain, quality of life measures, and multimodal imaging (X-ray, CT, and MRI). The primary outcome was conservative treatment failure. Independent predictors were identified using multivariate logistic regression and weighted to create the OVF-CTPS, which was validated using receiver operating characteristic (ROC) analysis. RESULTS: The conservative treatment failure rate was 29.9%. Six independent predictors were identified: Sugita "bow-shaped" or "concave" type, standing vertebral collapse degree