Objective To explore the effect of Shenglong Jiegu Capsules on postoperative recurrent fractures in elderly patients with osteoporotic thoracolumbar fractures (OTF),and to preliminarily analyze its mechanism of action based on the mechanism of bone morphogenetic protein 2/bone morphogenetic protein 7(BMP-2/BMP-7).Methods A total of 100 elderly OTF patients undergoing percutaneous vertebraplasty (PVP) in Nanchang Hongdu Hospital of TCM from January 2020 to October 2022 were selected as the study objects,and were divided into conventional group (50 cases)and capsule group(50 cases) according to random number table method.The conventional group was treated with conventional PVP,and patients in the capsule group were treated with Shenglong Jiegu Capsules on the basis of the conventional group.The vertebral structure (Cobb angle and anterior margin height ratio),serum BMP-2,BMP-7 levels before and after treatment,bone metabolism indicators (bone specific alkaline phosphatase [BALP],type I procollagen N-terminal peptide [PⅠNP],osteocalcin[OST]),bone mineral density(BMD),rehabilitation status(Oswestry lumbar dysfunction index[ODI])evaluation,Pain rating(visual analogue scale[VAS])score,clinical efficacy rate between,incidence of vertebral refractures and adverse reactions of two groups were compared.Results After treatment,the Cobb Angle of the two groups was improved,the height ratio of the anterior margin of the injured vertebra was better than that before treatment,and the capsule group was better than the conventional group,with statistical significances (P＜0.05).The expression levels of BMP-2 and BMP-7 in the capsule group were higher than those in the conventional group,with statistical significances(P＜0.05).All patients had good recurrence of fracture after operation,and the healing speed of capsule group was faster than that of conventional group,with statistical significances(P＜0.05).After treatment,BALP,PⅠNP and OST in capsule group were higher than those in conventional group,with statistical significances (P＜0.05).BMD in two groups was higher than before treatment and the capsule group was higher than that in conventional group,ODI score and VAS score were lower than before treatment and the capsule group was lower than that in conventional group,with statistical significances(P＜0.05).The total clinical effective rate of capsule group (95.0%) was higher than that of conventional group (80.0%),and the incidence of refracture of capsule group(4%)was lower than that of conventional group(18%),with statistical significances(P＜0.05).No obvious adverse reactions were observed in both groups.Conclusion Shenglong Jiegu Capsules can improve bone mineral density by up-regulating the levels of serum BMP-2 and BMP-7 in patients,thereby preventing postoperative fracture in elderly OTF.The mechanism may be related to Shenglong Jiegu Capsules can stimulate BMP signaling pathway and accelerate osteoblast differentiation.