Murata K, Matsuoka Y, Nishimura H, et al. - The case histories of 309 individuals with osteoporotic vertebral fracture (OVF) who underwent surgery was retrospectively reviewed by the experts in order to discover the predictors for the postoperative poor activity of daily living (ADL) in individuals with OVF. At the final follow-up period, the frequency of poor ADL was 9.1%. Preoperative neurological deficit, perioperative complication, absence of preoperative bone-modifying agent administration, and absence of postoperative recombinant human parathyroid hormone (rPTH) administration were significantly correlated in univariate analysis. Statistical importance was exhibited by the preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration in multivariate analysis. In conclusion, predictors for postoperative poor ADL in individuals with OVF were a preoperative neurological deficit, perioperative complication, and absence of postoperative rPTH administration. Neurological deficits and complications were frequently inevitable factors, thus, rPTH was a significant choice for postoperative treatment for OVF.