Osteoporosis Internationalhttp5/doi.org/10.1007/s00198-023-06688-9ORIGINAL ARTICLEInternational consensus on the non-pharmacological and non-surgicalmanagement of osteoporotic vertebral fracturesMatteo Ponzano2.N.Tibert3.S.Brien4.L.Funnell4.J.C.Gibbs5.H.Keller36.J.Laprade7.S.N.Morin.A.Papaioannou.Z.Weston11.T.H.Wideman2.L.M.GiangregorioReceived:28 March 2022/Accepted:26 January 2023International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2023AbstractSummary/Rationale We identified a knowledge gap in the non-pharmacological and non-surgical management of osteo-porotic vertebral fractures.Main results This international consensus process established multidisciplinary biopsychosocial recommendations on pain,nutrition,safe movement,and exercise for individuals with acute and chronic vertebral fractures.Significance These recommendations will guide clinical practice and inform interventions for future research.Purpose To establish international consensus on recommendations for the non-pharmacological and non-surgical manage-ment of osteoporotic vertebral fracturesMethods We adopted a five-step modified Delphi consensus process:(1)literature search and content analysis,(2)crea-tion of the survey,(3)selection of the expert panel,(4)first round of the rating process,and(5)second round of the ratingprocess.The first round included 49 statements and eight open-ended questions;the second round included 30 statements.Panelists were asked to rate their agreement with each of the statements using a 9-point scale,with the option to providefurther comments.Consensus for each statement was determined by counting the number of panelists whose rating wasoutside the 3-point region containing the median.Results We invited 76 people with degree in medicine,physiotherapy,kinesiology,and experience in the management ofosteoporotic vertebral;31(41%)and 27 (36%)experts agreed to participate to the first and the second round,respectively.The mean percentage agreement after the first and second rounds was 76.6%16.0%and 90.7%+6.5%,respectively.Weestablished consensus on recommendations on pain,early satiety,weight loss,bracing,safe movement,and exercise forindividuals with acute and chronic vertebral fractures.Conclusion Our international consensus provides multidisciplinary biopsychosocial recommendations to guide the manage-ment of osteoporotic vertebral fractures and inform interventions for future research.Keywords Education.Fragility fractures.Osteoporosis.Rehabilitation.SpineIntroductionkyphosis,which may lead to difficulties in performing dailyactivities.[1,8-10]Vertebral fractures are the most common type of fractureNon-pharmacological interventions such as exercise,in people with osteoporosis [1-3]and are associated withtaping,bracing,and spine-sparing strategies are sometimesseveral morbidities and increased mortality [4,5].One inused to improve posture and reduce pain,disability,andfive women with an incident osteoporotic vertebral fractur
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