Introduction: Cases in which surgery was performed for patients aged ≥90 years with osteoporotic vertebral fractures were investigated.

Methods: A total of 23 vertebrae of 22 patients aged ≥90 years or older with osteoporotic vertebral fractures (OVFs) who underwent surgical treatment at our hospital between 2011 and 2023 were retrospectively investigated. The investigation included age, sex, medical history, fractured vertebrae, preoperative bone density, preoperative waiting period, surgical procedures, surgical duration, length of hospital stay, and mobility at discharge.

Results: The average age was 91.8 years, with 6 males and 16 females. The most common pre-existing condition was hypertension, and the most frequently fractured vertebra was the first lumbar vertebra. The mean young adult mean (YAM) value was 62.14. The preoperative waiting period ranged from a minimum of 5 days to over one year. The surgical procedures included balloon kyphoplasty (BKP) alone, vertebral body stenting (VBS) alone, and a combination of BKP and pedicle screw fixation (PPS). The average surgery time was 24.7 minutes for BKP or VBS alone and 104.3 minutes for the combination of BKP and PPS. The average hospital stay was 29.6 days. At discharge, mobility outcomes were as follows: 11 patients used wheelchairs, 5 used walkers, 3 were ambulatory without assistance, and 3 used canes. There were no cases of severe postoperative complications.

Conclusions: Complications and decreaced activities of daily living due to OVF in patients aged ≥90 years are unavoidable. Although the usefulness of surgeries such as BKP has been reported, the hurdles for performing such procedures are not low.