OBJECTIVE: To evaluate the clinical efficacy and safety of vertebroplasty for the treatment of ultra-high-aged patients with vertebral compression fractures over 90 years of age. METHODS: The clinical data of 56 patients over 90 years of age with vertebral compression fractures treated with retrobulbar kyphoplasty in the Department of Orthopaedics of Beijing Hospital were retrospectively analyzed. Patients were evaluated for pain, pain medication, cement spillage and assessment of whether vertebral re-fracture occurred. Pain scores, analgesic medication dosage, mobility and the occurrence of postoperative complications such as cement leakage and re-fracture were recorded preoperatively, 3 days postoperatively and during the final follow-up. RESULTS: The mean follow-up time was 18.6 months (6 to 32 months) in 56 patients. The preoperative VAS score was 7.12±2.14, which changed to 2.58±1.12 and 1.76±0.72 at 3 days postoperatively and at the last follow-up; the analgesic medication score changed from 2.02±1.68 preoperatively to 1.43±0.54 and 1.13±0.71 at 3 days postoperatively and at the last follow-up; the mobility score changed from 2.52±0.64 preoperatively to 1.2±0.64 at 3 days postoperatively and at the last follow-up. Complications: cement leakage in 10 cases (17.9%), vertebral re-fracture in 6 cases (10.7%), cerebrospinal fluid leakage in 3 cases (5.3%), and nerve root irritation in 2 cases (3.6%), all of which were transient and resolved after symptomatic treatment and recovered well at the last follow-up. CONCLUSION: Posterior convex plasty for the treatment of osteoporotic spinal compression fractures in patients over 90 years of age significantly reduces pain associated with the fracture, reduces analgesic drug use, and improves spinal mobility. It can be used as a safe and effective minimally invasive treatment. Zhang (10), Department of Orthopedics, Beijing Hospital