GIRFT has shared a new national pathway aiming to standardise and implement best practice for NHS patients in England with vertebral fragility fractures (VFF).
The GIRFT VFF thoracolumbar pathway is the result of an in-depth collaboration between multiple, cross-specialty stakeholders and is supported and co-badged by professional organisations* from across the patient pathway.
It offers best practice guidance for the care of non-ambulatory patients who are unable to mobilise (sometimes despite pain relief and physiotherapy) and covers all stages of the patient journey – from presentation to admission and initial care, ongoing ward care and discharge and follow-up.
Vertebral fragility fractures are fractures that occur in the vertebrae due to low-energy trauma such as a fall from standing height. They often indicate underlying bone fragility and are typically associated with osteoporosis. The risk of vertebral fracture increases with age, particularly after the age of 50, as bone density decreases.
GIRFT’s national report for spinal services (2019) identified wide variation in the use of interventions for improving the symptoms of pain associated with these fractures. The new pathway identifies best practice based on data from spinal units across England and recommends concepts teams can adopt to work towards a more equitable service, using existing resources.
The VFF pathway aligns with and is linked to GIRFT’s non-ambulatory fragility fracture pathway which was launched last year to ensure patients with all types of fragility fracture receive excellent and equitable NHS care.
Mike Hutton, GIRFT’s clinical lead for spinal services, led the working group which developed the VFF pathway. He said:
“This pathway has been a long time in development, so we are delighted to share the end result, demonstrating what the data shows as best practice for this large cohort of patients. Our hope is that colleagues working at every stage of pathway will download it and work towards implementation. Over time we are confident that it will result in improved patient outcomes and better cost effectiveness for the NHS.”
*The GIRFT VFF pathway is supported and co-badged by:
- British Association of Spine Surgeons (BASS)
- Association of Trauma and Orthopaedic Chartered Physiotherapists (ATOCP)
- British Geriatrics Society (BGS)
- British Orthopaedic Association (BOA)
- Fragility Fracture Network UK
- Royal Osteoporosis Society (ROS)
GIRFT’s pathway for best practice in caring for patients with vertebral fragility fractures webinar.
Mike Hutton, GIRFT’s clinical lead for spinal services, is hosting a webinar to launch our new national pathway aiming to standardise and implement best practice for NHS patients in England with vertebral fragility fractures (VFF).
Wednesday 12 November 2025
12.30pm to 1.30pm
