Abstract: With the aggravation of aged population in China, the number of patients with osteoporotic vertebral compression fractures is increasing year by year. At present, conservative treatment can help patients relieve pain within a few weeks, so it is considered as the first-line treatment, but there are still a considerable number of patients with poor effect by conservative treatment. This study reviewed the risk factors of failure in conservative treatment of patients with osteoporotic vertebral compression fractures from the aspects of vertebral collapse degree, nerve injury, age, underlying diseases, mineral density of bone, body mass index, and modified frailty index.