[Evidence-based clinical guideline on thoracolumbar internal fixation for elderly patients with osteoporosis (2025 edition)].

The incidence of osteoporosis increases significantly with age. When elderly patients require internal fixation due to degenerative changes or trauma in the thoracolumbar spine, concomitant osteoporosis considerably elevates surgical difficulty and risk. Common complications include screw loosening, internal fixation failure, and nonunion of bone grafts, posing substantial challenges to spine surgeons. Currently, there is a lack of relevant clinical standards or guidelines for the application of thoracolumbar internal fixation in elderly patients with osteoporosis. To address this gap, based on the principles of evidence-based medicine, integrating scientific rigor with practicality, conducting a systematic review and analysis of relevant literature, the Innovation and Transformation Group of the Chinese Orthopaedic Association and the Spine Trauma Group of the Chinese Association of Orthopaedic Surgeons and the Orthopedic Minimally Invasive Injury Professional Committee of Shaanxi Province Association of Orthopedic Surgeons jointly led an expert initiative leading to the development of this guideline. Recommendations are proposed primarily covering preoperative education, surgical strategies, intraoperative considerations, and postoperative rehabilitation, aiming to standardize the clinical application of this technique.