Abstract: Objective To investigate the relationship between the risk of osteoporotic fracture and spine activity and spinal curvature in the elderly. Methods A total of 90 cases of elderly patients who met the inclusion criteria was collected.he probability of hip fractures and the probability of osteoporotic fracture were evaluated by using the fracture risk assessment tool.Spinalmouse was used to measure the trunk inclination angle,curvature of spine,angle of intervertebral space of spine of upright position,forward flexion,backward extension,and weight-bearing position. Results The risk probability of hip fracture was positively correlated with trunk tilt angle and T_7/8 angle (P<0.05).The risk probability of main osteoporotic fracture was positively correlated with trunk tilt angle and T_7/8 angle (P<0.05).The risk probability of hip fracture was positively correlated with upright lumbar curve and upright thoracic curve (P<0.05).The risk probability of main osteoporotic fracture was positively correlated with the upright to forward flexion lumbar curvature and upright thoracic curve (P<0.05).The risk of hip fracture was negatively correlated with the change of the upright to forward flexion thoracic curve (P<0.05),but there was no significant correlation with the changes of the upright to forward flexion lumbar curvature,the upright to backward extension lumbar curvature and the upright to backward extension thoracic curve (P>0.05).The risk probability of the main osteoporotic fracture was negatively correlated with the change of the upright to forward flexion thoracic curvature (P<0.05),but there was no significant correlation with the changes of the upright to forward flexion lumbar curvature,the upright to backward extension lumbar curvature and the upright to backward extension thoracic curve (P>0.05).There was positive correlation between hip fracture and weight-bearing anteversion change and weight-bearing chest bending change (P<0.05),but there was no significant correlation with the weight-bearing lumbar curve change (P>0.05).The risk probability of main osteoporotic fracture was positively correlated with the changes of weight-bearing anteversion and weight-bearing chest bending (P<0.05),but there was no significant correlation with the weight-bearing lumbar curve change (P>0.05). Conclusion The risk of osteoporotic fractures in the elderly is related to spinal capacity and spinal curvature.Spinal activity and spine morphology can reflect the risk of osteoporotic fractures.