Objective To assess the level of knowledge and influencing factors related to osteoporosis in elderly patients with osteoporotic vertebral fractures after surgery in China，providing a basis for improving their understanding. Methods A total of 5 955 elderly patients with osteoporotic vertebral fractures in 31 provinces （autonomous regions and municipalities） were selected as survey subjects from September to November 2023. A general information questionnaire and an osteoporosis knowledge assessment tool were used for a cross-sectional survey. The univariate analysis and logistic regression were used to analyze the influencing factors. Results 5 248 valid questionnaires were collected，and the effective questionnaire recovery rate was 88.13%.The score of osteoporosis knowledge assessment tool of elderly patients with osteoporotic vertebral fractures after surgery was 11.00（7.00，13.00）. 70.03% of the patients had poor knowledge of osteoporosis. The location of the hospital（eastern region hospitals），presence of tumors, past surgical history，admission for falls，diagnosis of severe osteoporosis，postoperative complications，use of walking aids，use of anti-osteoporosis drugs，osteoporosis health education，fall prevention health education，and health education forms（video，telephone，manual，and WeChat） were the influencing factors of osteoporosis knowledge in elderly patients with osteoporotic vertebral fractures after surgery（P<0.05）. Conclusion The osteoporosis knowledge of elderly patients with osteoporotic vertebral fractures after surgery needs to be improved. To help the secondary prevention of osteoporosis，the standardized osteoporosis health education should be strengthened，and attention should be paid to key groups.
