We have read the article by Girardo et al. [1] entitled “Long versus short segment instrumentation in osteoporotic thoracolumbar vertebral fracture” with great interest and congratulate the authors for this thought-provoking topic of interest; however, there are few pertinent queries that need to be addressed:

(1) There is heterogeneity in the management of osteoporotic fractures (OF) 4 type fractures. OF 4 types were managed by long as well as short segment instrumentation in the study. Factors responsible for the decision of long or short segment stabilization is not mentioned and this needs to be clarified for further understanding.

(2) Only a single patient had proximal junctional kyphosis in both, long segment and short segment instrumentation groups. This became significant in terms of pvalue which can be misleading and can be misinterpreted.

(3) Only 37 subjects for the study cohort are too small a sample to come to a concrete conclusion [2].