Surgical treatment of the osteoporotic spine is a treatment of last resort, when all less invasive options have failed. Medical therapy and core strength building act to reduce spinal injury, however, injuries will continue to occur. Surgical care for injuries to the osteoporotic spine is complex and relies on limited literature. Surgical spinal intervention in general has never been more advanced. However, the objective evidence for intervention has never been more assailed. To definitively answer critical questions about spinal interventions, a system that records data for every clinical encounter, in perpetuity, is needed. The data on each patient encounter needs to be organized to permit easy search and analysis thus permitting, for the first time, continuous quality improvement and hypothesis driven research. Innovations are new idea, device or process. Innovations are the application of better solutions that meet new requirements, inarticulated needs or existing market needs.