Epidemiology and Future Burden of Vertebral Fractures: Insights From the Global Burden of Disease 1990–2021

Background/Objectives: Vertebral fractures (VFs) are a global health issue caused by traumatic or pathological factors that compromise spinal integrity. With an aging population, the burden of VFs is increasing, particularly in older adults. Methods: Data from the Global Burden of Disease 2021 were analyzed to estimate the prevalence, mortality, and years lived with disability due to traumatic vertebral fractures from 1990 to 2021. Estimates were stratified according to age, sex, and region. Bayesian meta-regression models were used to generate age-standardized rates, and projections to 2050 were calculated using demographic trends and the socio-demographic index. Das Gupta’s decomposition assessed the relative contributions of population growth, aging, and prevalence changes to future case numbers. Results: In 2021, approximately 5.37 million people (95% UI: 4.70–6.20 million) experienced VFs globally, with an age-standardized prevalence of 65 per 100,000. Although rates have declined slightly since 1990, the absolute burden has increased owing to population aging. VF prevalence was the highest in Eastern and Western Europe and high-income regions. Males had higher VF rates until 70 years, after which female rates surpassed them, reflecting postmenopausal osteoporosis. Falls and road injuries were the leading causes of VF. By 2050, VF cases are projected to rise to 8.01 million (95% UI: 6.57–8.64 million). Conclusions: Although age-standardized VF rates have decreased slightly, the global burden continues to increase. Targeted strategies for early diagnosis, management of osteoporosis, and fall prevention are required to reduce the impact of VFs.