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STUDY DESIGN Prospective cohort study. OBJECTIVE To characterize a patient population with nonunion after acute osteoporotic vertebral fractures (OVFs) and compare the union and nonunion groups to identify risk factors for nonunion. SUMMARY OF BACKGROUND DATA While OVFs are the most common type of osteoporotic fracture, the predictive value of a clinical assessment for nonunion at 48 weeks after OVF has not been extensively studied. METHODS This prospective multicenter cohort study included female patients aged 65 to 85 years with acute on