Objective To observe the changes in bone mineral density (BMD) and bone metabolism indices in the elderly women in 6 to 12 months after lumbar vertebra fracture, and investigate their correlations so as to provide theoretical basis for the clinical application of bone metabolism indices to effectively prevent secondary fracture. Methods Forty-eight elderly women meeting our inclusion and exclusion criteria of lumbar vertebra fracture were recruited in this study. The standards for follow-up were set up to measure the BMD in the fractured vertebra, healthy vertebra and the hips in 3d, and 6 and 12 months after fracture, and to determine the serum levels of bone metabolism indices, including bone alkaline phosphatase (BAP), bone γ-carboxyglutamic acid containing proteins (BGP, osteocalcin), carboxy-terminal cross-linking telopeptide of type Ⅰ collagen (CTX-Ⅰ) and tartrate-resistant acid phosphatase 5b (TRACP5b) in 4h (as baseline), 3d, 6 and 12 months after fracture. CT scanning was used to evaluate the bone healing in 4 and 6 months after fracture. All the data were recorded, analyzed and processed with SPSS 17.0 statistical software. Results After fracture healing, the BMD value was significantly lower than the baseline value in the fractured and healthy vertebra (P＜0.01), and not statistically different with baseline value in the hips. In 6 months after fracture, the serum levels of BAP, BGP, CTX-Ⅰ and TRACP5b were significantly higher than the baseline values (P＜0.05). In 12 months after fracture, namely 6 months after fracture healing, the serum level of BGP was obviously higher than the baseline value (P＜0.01), while the other indices of bone metabolism showed no statistical difference with the baseline values. When the fracture healing reached the clinical and radiographic standards, the partial regression coefficient of delta-Zscore was maximal between the change in serum BGP level and the change in BMD of the fractured vertebra. Conclusion When the fracture reaching clinical healing, the serum level of BGP is of great value in the assessment of recovering speed of BMD. Monitoring corresponding bone metabolism indices after fracture healing improves the accuracy of judging BMD changes and reduces the risk of secondary fractures.