A predictive mechanical model for evaluating vertebral fracture probability in lumbar spine under different osteoporotic drug therapies

•Method for estimating the fracture risk in osteoporotic patients based on Damage and Fracture Mechanics and DXA measurements.•The method evaluates the evolution over time of the mechanical strength of bone from BMD, for different treatments.•Evolutionary algorithm and a finite element model of the lumbar spine allow the prediction of fracture probability.•The incorporation of clinical measurements and simulation results will be useful for an individualized treatment in patients.•The model predicts the evolution of vertebral fracture probability and the expected evolution under different therapies.