Gender disparities in the treatment and outcome of osteoporotic thoracolumbar vertebral fractures - results from the prospective EOFTT multicenter study.

Authors

Philipp Schenk, Helena Arias, Ulrich J A Spiegl, Sebastian Katscher, Klaus J Schnake, Martin Bäumlein, Volker Zimmermann, Gregor Schmeiser, Michael A Scherer, Michael Müller, Kai Sprengel, Katja Liepold, Simon Schramm, Christopher Baron, Holger Siekmann, Falko Schwarz, Alexander Franck, Max J Scheyerer, Bernhard Ullrich, Georg Osterhoff, Working Group Osteoporotic Fractures Spine Section

Published in

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. Aug 13, 2026. Epub Aug 13, 2026.

Abstract

Osteoporotic vertebral fractures (OVF) present varying treatment challenges depending on fracture severity, stability, and patient characteristics. While the OF classification system guides treatment decisions, gender differences in OVF management and outcomes remain underexplored.
How do treatment strategies and clinical outcomes differ between genders?
This secondary analysis utilized prospective data from the German multicenter EOFTT study, including 518 patients (390 females, 128 males) treated for thoracolumbar OVF. Outcomes assessed included adherence to OF score recommendations, pain levels, functional performance (Timed Up & Go test, Barthel Index, Oswestry Disability Index), and rates of anti-osteoporotic therapy (aoTh). Statistical analyses included generalized linear mixed models and repeated-measures general linear models, with therapy type as a covariate.
Gender did not influence overall treatment choice; however, men more frequently underwent instrumentation, while women received augmentation procedures. AoTh administration was significantly lower in men at discharge (72% vs. 82%, p = 0.017) and follow-up (71% vs. 89%, p < 0.001). Both genders showed significant improvements in pain, mobility, and functional outcomes over time (p < 0.001), with no gender-specific differences. Adherence to OF score recommendations was 61% with no gender disparity.
Although gender had minimal influence on pain and functional recovery, marked differences in surgical strategies and the administration of anti-osteoporotic therapy underscore potential disparities in the surgical treatment of women and the management of osteoporosis in men. Addressing these disparities through tailored screening, optimized adherence to guidelines, and individualized treatment strategies may improve outcomes in OVF management.

PMID:
42593510
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.

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