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Time-to-event analysis was conducted for postoperative outcome. Outcome-related factors were explored with a multivariable Cox proportional hazards model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094870) consisted of 2675 patients in the percutaneous vertebroplasty (PVP) group and 2195 in the spine fusion surgery (SFS) group. Most patients had lumbar VFs, and posterior spinal fusion was common in the SFS group. Approximately 20% of patients did not receive prescriptions for osteoporosis medications during the perioperative period. Most reoperations and subsequent fractures occurred within 90\u00a0days after PVP or SFS. In the PVP group, degenerative spine disease (adjusted hazard ratio 1.34 [95% CI, 1.03\u20131.76]), psychotropic drugs (1.34 [1.03\u20131.76]), and glucocorticoid prescriptions with a mean dose of\u2009\u2265\u20095 to\u2009&lt;\u20097.5\u00a0mg\/day (2.35 [1.04\u20135.34]) (vs.\u2009&lt;\u20091\u00a0mg\/day) were associated with reoperation. In post hoc subgroup analysis by year of spine surgery, anabolic agents were associated with a lower risk of reoperation (0.48 [0.30\u20130.75]) in 2019 and later. In the SFS group, hyperparathyroidism and Parkinson\u2019s disease were associated with reoperation (2.14 [1.03\u20134.44] and 2.10 [1.31\u20133.37], respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Perioperative osteoporosis medication may be suboptimal. Factors associated with postoperative outcomes must be considered, with the strategic goal of improving patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00774-025-01639-2","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:53:20Z","timestamp":1758088400000},"page":"649-661","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preoperative treatment and postoperative outcomes in osteoporotic patients with vertebral fractures: a longitudinal database study"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9201-1273","authenticated-orcid":false,"given":"Ruriko","family":"Koto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiori","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7804-7317","authenticated-orcid":false,"given":"Tetsuya","family":"Miwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohisa","family":"Miyakoshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"1639_CR1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","volume":"17","author":"O Jonell","year":"2006","unstructured":"Jonell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. 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NM has received honoraria for speaking at symposia from Teijin Healthcare Limited, Asahi Kasei Pharma Corporation, Amgen K.K., Astellas Pharma Inc., and Daiichi Sankyo Company, Limited.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The research reported in this paper does not involve any studies of human or animal subjects performed by any of the authors. All data were obtained from a large health insurance claims database and were fully anonymized. No informed consent from individual patients or approval from an Institutional Review Board (IRB) was required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}