{"id":63022,"date":"2026-04-28T14:27:08","date_gmt":"2026-04-28T07:27:08","guid":{"rendered":"https:\/\/www2.si.mahidol.ac.th\/en\/?p=63022"},"modified":"2026-04-29T09:35:40","modified_gmt":"2026-04-29T02:35:40","slug":"spinal-fracture-surgery-in-the-elderly-treatment-options-for-sustainable-quality-of-life-recovery","status":"publish","type":"post","link":"https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/spinal-fracture-surgery-in-the-elderly-treatment-options-for-sustainable-quality-of-life-recovery\/","title":{"rendered":"Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery"},"content":{"rendered":"<div id='av_section_1'  class='avia-section av-bs06ivi-3f86837c91af6ba45ca5d052708b6242 main_color avia-section-small avia-no-border-styling  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><main  role=\"main\" 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https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-211x300.jpg 211w\" sizes=\"(max-width: 327px) 100vw, 327px\" \/><\/div><\/div><\/div><\/div><div  class='flex_column av-a0j2pym-bc8530c9561e44d5dadc9e2d89265a8e av_one_fifth  avia-builder-el-6  el_after_av_three_fifth  avia-builder-el-last  flex_column_div  '     ><\/div>\n\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_3'  class='avia-section av-996g1pq-e7413c24bbb20c41ea2fe572403f986d main_color avia-section-default avia-no-border-styling  avia-builder-el-7  el_after_av_section  el_before_av_section  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-63022'><div class='entry-content-wrapper clearfix'>\n<div  class='flex_column av-93ojk8e-8d0b7f2f618968050a75729561cd7355 av_one_fifth  avia-builder-el-8  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div  '     ><\/div><div  class='flex_column av-8eq4gdq-4e7a0a3c11597bdc03195e8a37944432 av_three_fifth  avia-builder-el-9  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  '     ><section  class='av_textblock_section av-moi9rxqo-3490687b72c49b36ec5fae2f9cce6bb3 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><h1 class=\"text-3xl font-semibold mt-6 mb-2\">Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery<\/h1>\n<\/div><\/section><\/div><div  class='flex_column av-t88q1a-40cfe405cd1b2762ed2c1c5be0a2fb0f av_one_fifth  avia-builder-el-11  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  '     ><\/div><div  class='flex_column av-7sr3y26-95b1ad75682fc270d9f1fac51872e436 av_one_fifth  avia-builder-el-12  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-7b38zzi-fd613d0133c0492baad385bd3e378968 av_three_fifth  avia-builder-el-13  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><p><section  class='av_textblock_section av-moi9u0oz-59a6c4225a90e925cc509b48282e2f68 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-63037\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e19\u0e1e.\u0e1a\u0e23\u0e34\u0e27\u0e31\u0e12\u0e19\u0e4c-\u0e2a\u0e31\u0e19\u0e15\u0e34\u0e20\u0e32\u0e29.jpg\" alt=\"\" width=\"200\" height=\"300\" \/><\/p>\n<p><em>By Lecturer Borriwan Santipas, M.D.<\/em><\/p>\n<p><em>Division of Spine Surgery, Department of Orthopaedic Surgery<\/em><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-moi9zrmd-cff5af844a1ed9281c661bad065f84a0\">\n#top .av_textblock_section.av-moi9zrmd-cff5af844a1ed9281c661bad065f84a0 .avia_textblock{\ncolumn-count:2;\n}\n<\/style>\n<section  class='av_textblock_section av-moi9zrmd-cff5af844a1ed9281c661bad065f84a0 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock av_multi_colums'  itemprop=\"text\" ><p><strong>Introduction<\/strong><\/p>\n<p>Osteoporotic Vertebral Fracture (OVF) is becoming a significant health crisis in aging societies worldwide, including Thailand. Recent statistical data reveals that the global patient population has increased rapidly by 38%, rising from 6.2 million people in 1990 to over 8.6 million people in 2019. This condition typically occurs at points where bone impact resistance is compromised, resulting in severe back pain, loss of mobility, and if not appropriately treated, may lead to permanent disability.<\/p>\n<p><strong>Fracture Classification and Treatment Approaches (OF Classification)<\/strong><\/p>\n<p>Currently, the OF Classification system (according to the German Society for Orthopaedics and Trauma Surgery \u2013 DGOU standards) is used to categorize severity levels based on spinal bone damage characteristics into 5 levels (OF 1\u20135).<\/p>\n<p><strong>Most commonly encountered groups:<\/strong><br \/>\n&#8211; <strong>OF3 type<\/strong> (approximately 42%): significant vertebral body collapse<br \/>\n&#8211; <strong>OF4 type<\/strong> (approximately 27%): severe damage to both superior and inferior endplates<\/p>\n<p><strong>Differential treatment approaches:<\/strong> For non-severe fractures (such as OF1 or OF2), physicians may recommend non-surgical treatment, including back bracing combined with physiotherapy. For OF3-5 fractures with high spinal instability, physicians typically recommend surgical intervention using various appropriate methods according to fracture type, such as metallic screw fixation, cement injection, or bone structure augmentation surgery. However, treatment decisions remain at the discretion of the treating physician.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-63024\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01.jpg\" alt=\"\" width=\"601\" height=\"202\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01.jpg 601w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01-300x101.jpg 300w\" sizes=\"auto, (max-width: 601px) 100vw, 601px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-63025\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e011.jpg\" alt=\"\" width=\"601\" height=\"413\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e011.jpg 601w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e011-300x206.jpg 300w\" sizes=\"auto, (max-width: 601px) 100vw, 601px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-63026\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e012.jpg\" alt=\"\" width=\"601\" height=\"169\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e012.jpg 601w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e01\u0e23\u0e30\u0e14\u0e39\u0e012-300x84.jpg 300w\" sizes=\"auto, (max-width: 601px) 100vw, 601px\" \/><\/p>\n<p><strong>Treatment Challenges: Which Method Provides Optimal Ambulation Recovery?<\/strong><\/p>\n<p>Currently, there are two main standard surgical approaches for treating commonly encountered OF3-4 osteoporotic vertebral fractures:<\/p>\n<p>1. <strong>Vertebroplasty (VP):<\/strong> Focus on injecting bone cement into the fracture site to reduce pain<br \/>\n2. <strong>Short-segment posterior instrumentation with vertebroplasty:<\/strong> A more complex surgical procedure using metallic screws for structural support combined with cement augmentation<\/p>\n<p>While cement injection alone is a rapid procedure, the research question that investigators sought to answer was: &#8220;Which method provides patients with better quality of life?&#8221;<\/p>\n<p><strong>Research Results<\/strong><\/p>\n<p>Following 1-year post-operative follow-up, significant findings include:<\/p>\n<p><strong>Quality of Life:<\/strong> The short-segment posterior instrumentation with vertebroplasty group demonstrated statistically significantly superior outcomes, with better Oswestry Disability Index (ODI) scores and EQ-5D quality of life scores.<\/p>\n<p><strong>Radiographic Outcomes:<\/strong> Spinal alignment in the short-segment posterior instrumentation with vertebroplasty group achieved superior sagittal angle correction.<\/p>\n<p><strong>Intraoperative Data:<\/strong> The short-segment posterior instrumentation with vertebroplasty group had significantly longer operative time and greater blood loss compared to the VP group.<\/p>\n<p><strong>Safety Profile:<\/strong> No statistically significant differences were found in complication rates, kyphotic progression, adjacent-level fractures, or revision surgery rates.<\/p>\n<p><strong>Conclusion<\/strong><\/p>\n<p>Treatment of osteoporotic vertebral fractures with short-segment posterior instrumentation combined with vertebroplasty provides superior radiographic spinal alignment outcomes and patient quality of life compared to vertebroplasty alone at 1-year post-operatively, despite increased risks of blood loss and extended operative time. Surgeons will consider appropriate treatment methods for individual patients using comprehensive data beyond radiographic diagnosis alone.<\/p>\n<\/div><\/section><\/p><\/div><div  class='flex_column av-ns6oj2-6e093b50dda66528eb3e917ee2bf680e av_one_fifth  avia-builder-el-16  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-690efm6-182895f49c1e36206dfa2ab0389480b5 av_one_fifth  avia-builder-el-17  el_after_av_one_fifth  el_before_av_one_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-5yvk03y-7c0e815f7770f21eb789c87df666e669 av_one_fifth  avia-builder-el-18  el_after_av_one_fifth  avia-builder-el-last  flex_column_div  column-top-margin'     ><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_4'  class='avia-section av-5bnvzf2-7283a8d0d194f2939a8a132f3d8ede44 main_color avia-section-default avia-no-border-styling  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Executive\u2019s Visits to Siriraj Centers of Research Excellence (SiCOREs) during 2024\u20132026\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-06-17T17:52:21+07:00\" >June 17, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/executives-visits-to-siriraj-centers-of-research-excellence-sicores-during-2024-2026\/' title='Link to: Executive\u2019s Visits to Siriraj Centers of Research Excellence (SiCOREs) during 2024\u20132026'>Executive\u2019s Visits to Siriraj Centers of Research Excellence (SiCOREs) during 2024\u20132026<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-63308 av-magazine-format-standard av-magazine-type-post av-magazine-entry-2 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div 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aria-label=\"Post: The Siriraj Medical Elective Program 2027 (AY2026) is now accepting applications.\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-06-15T16:20:14+07:00\" >June 15, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/the-siriraj-medical-elective-program-2027-ay2026-is-now-accepting-applications\/' title='Link to: The Siriraj Medical Elective Program 2027 (AY2026) is now accepting applications.'>The Siriraj Medical Elective Program 2027 (AY2026) is now accepting applications.<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-63256 av-magazine-format-standard av-magazine-type-post av-magazine-entry-3 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/training-workshop-on-academic-career-advancement-for-support-personnel-of-the-siriraj-centers-of-research-excellence\/' title='Link to: Training Workshop on Academic Career Advancement for Support Personnel of the Siriraj Centers of Research Excellence' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/News-\u0e04\u0e27\u0e32\u0e21\u0e01\u0e49\u0e32\u0e27\u0e2b\u0e19\u0e49\u0e32-1-80x80.png\" class=\"wp-image-63257 avia-img-lazy-loading-not-63257 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/News-\u0e04\u0e27\u0e32\u0e21\u0e01\u0e49\u0e32\u0e27\u0e2b\u0e19\u0e49\u0e32-1-80x80.png 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/News-\u0e04\u0e27\u0e32\u0e21\u0e01\u0e49\u0e32\u0e27\u0e2b\u0e19\u0e49\u0e32-1-36x36.png 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/News-\u0e04\u0e27\u0e32\u0e21\u0e01\u0e49\u0e32\u0e27\u0e2b\u0e19\u0e49\u0e32-1-180x180.png 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Training Workshop on Academic Career Advancement for Support Personnel of the Siriraj Centers of Research Excellence\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-06-12T16:40:02+07:00\" >June 12, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/training-workshop-on-academic-career-advancement-for-support-personnel-of-the-siriraj-centers-of-research-excellence\/' title='Link to: Training Workshop on Academic Career Advancement for Support Personnel of the Siriraj Centers of Research Excellence'>Training Workshop on Academic Career Advancement for Support Personnel of the Siriraj Centers of Research Excellence<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-63252 av-magazine-format-standard av-magazine-type-post av-magazine-entry-4 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-joins-the-nation-in-mourning-the-passing-of-hrh-princess-bajrakitiyabha\/' title='Link to: Siriraj Joins the Nation in Mourning the Passing of HRH Princess Bajrakitiyabha' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/723510362_1444084804430945_6352322164133292350_n-80x80.jpg\" class=\"wp-image-63253 avia-img-lazy-loading-not-63253 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/723510362_1444084804430945_6352322164133292350_n-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/723510362_1444084804430945_6352322164133292350_n-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/723510362_1444084804430945_6352322164133292350_n-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Siriraj Joins the Nation in Mourning the Passing of HRH Princess Bajrakitiyabha\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-06-12T09:11:34+07:00\" >June 12, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-joins-the-nation-in-mourning-the-passing-of-hrh-princess-bajrakitiyabha\/' title='Link to: Siriraj Joins the Nation in Mourning the Passing of HRH Princess Bajrakitiyabha'>Siriraj Joins the Nation in Mourning the Passing of HRH Princess Bajrakitiyabha<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-63234 av-magazine-format-standard av-magazine-type-post av-magazine-entry-5 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-international-visiting-scholar-at-department-of-surgery\/' title='Link to: Siriraj International Visiting Scholar at Department of Surgery' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/S__22175762_0-80x80.jpg\" class=\"wp-image-63235 avia-img-lazy-loading-not-63235 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/S__22175762_0-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/S__22175762_0-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/06\/S__22175762_0-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Siriraj International Visiting Scholar at Department of Surgery\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-06-09T11:44:36+07:00\" >June 9, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-international-visiting-scholar-at-department-of-surgery\/' title='Link to: Siriraj International Visiting Scholar at Department of Surgery'>Siriraj International Visiting Scholar at Department of Surgery<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/div><\/div><\/div><div  class='flex_column av-2r7qvta-28c0bb5d7abb9416c466c01c81a83349 av_one_fifth  avia-builder-el-25  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-2aj932m-019cde6912daed12f985dab7231da6ba av_one_fifth  avia-builder-el-26  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-1tvrq26-4aa9d063171172acee8359578dcd5274 av_three_fifth  avia-builder-el-27  el_after_av_one_fifth  el_before_av_one_fifth  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