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34pelvis. When an OVF occurs, the lumbar spine loses its shape and straightens. In response to this, the pelvis tilts forward naturally. This is a condi-tion in which the pelvis compensates for the decrease in lordosis of the lumbar spine. If another OVF occurs in this state, the lordosis of the lumbar spine disappears, and in some cases, the lumbar spine may progress to kyphosis. At this point, the pelvis can no longer compensate and the entire body is tilted forward. In order for people in this state to stand upright, they need to use their back muscle to the fullest. However, this causes the back muscle to become tired after a while. This spinal deformity may be surgically cured, but it is so inva-sive that it is not practical for most older people. Therefore, the patient must accept this condition. For patients with such conditions, we recommend resting when in pain, sitting when working in the kitchen, and using a walker. This is the state of “locomotive syndrome” mentioned above. Before reaching this state, OVF need to be healed quickly. People have been found to lose 3% of their muscle strength after resting for a day. Decreased activity leads to reduced life expectancy and reduced healthy life expectancy. What does it mean to heal an OVF quickly? It is important to relieve the pain quickly, for the patient to be able to move from an early stage, and to Figure 2　Balloon kyphoplasty for osteoporotic vertebral fracturereturn to their normal life without losing muscle strength. One of the quickest treatments is an operation called balloon kyphoplasty (BKP) (Figure 2). The crushed bone is inflated with a balloon and cement is injected, allowing the patient to stand and walk the day after surgery. The frac-ture can be cured very quickly, but in most cases surgery is not immediate due to the amount of preparation required. We have investigated how to cure an OVF quickly. Specifically, we compared the period of improvement in pain caused by OVF between a group treated with BKP and a non-sur-gery group. The results showed that the average time from the onset of pain to improvement was 12.7 weeks in the surgery group and 10.0 weeks in the non-surgery group, which means that the pain improved faster without surgery. The problem with this is that it takes a long time to perform surgery, and it makes no sense to have surgery early. In fact, other studies have shown that people who have undergone BKP are less likely to develop other illnesses and have a longer lifespan than those who have been cured without surgery13-15). This shows the importance of quickly healing an OVF. Summarizing the treatment of OVF, the initial pain can be expected to improve in about 10 weeks without surgery. During that time, if the patient is unable to move due to pain, the patient’s