European Spine Journal · IF 2.8 · August 13, 2026 · LoE II
Gender disparities in the treatment and outcome of osteoporotic thoracolumbar vertebral fractures – results from the prospective EOFTT multicenter study
Philipp Schenk, Helena Arias, Ulrich J. A. Spiegl, S. Katscher, Klaus J. Schnake, Martin Bäumlein, Volker Zimmermann, Gregor Schmeiser, Michael Scherer, Michael Müller, Kai Sprengel, Katja Liepold — BG Klinikum Bergmannstrost Halle
This secondary analysis of the German EOFTT multicenter cohort compared 128 men and 390 women treated for osteoporotic thoracolumbar vertebral fractures to see if treatment and outcomes differed by gender. Men underwent instrumentation more often while women more often had augmentation-only procedures, and men received anti-osteoporotic therapy less often than women both at discharge (72% vs 82%, p=0.017) and follow-up (71% vs 89%, p<0.001), even though pain and functional recovery (ODI, TUG, Barthel) improved similarly in both groups over time.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersHighlights a real-world undertreatment gap for osteoporosis in men after vertebral fractures, and a difference in surgical technique choice between genders that could affect future fracture risk or reoperation, both relevant to surgeons managing these patients.
Conclusion strengthConfirms prior evidence
The conclusions are not supported by the reported results.
Presenting this at rounds? Start here
- ?Should men presenting with osteoporotic vertebral fractures be flagged for more aggressive osteoporosis screening and treatment initiation given this persistent gap in anti-osteoporotic therapy uptake?
- ?Does the finding that women more often receive augmentation-only rather than instrumentation despite similar fracture severity and bone quality warrant reconsideration of how surgical technique is selected, independent of gender?