To observe the clinical results of percutaneous vertebral retrobulbar kyphoplasty in pathological fractures of the thoracolumbar spine in the elderly. Methods: From October 2005 to October 2007, 15 cases of 17 vertebrae, aged 70-89 years, with a mean age of 78 years, 6 cases of metastatic cancer, 7 cases of osteoporotic fracture, and 2 cases of multiple myeloma, who underwent vertebral retroconvex plasty with the Sky Bone Expansion System were compared before and after surgery for VAS scores and height of the anterior, midline, and posterior margins of the diseased vertebrae, the angle of retroconvexity of the thoracolumbar segment, and postoperative The results were statistically analyzed by paired t-test. Results: All patients were discharged from the hospital with an average length of stay of 5.5 days; two vertebrae showed cement leakage to the anterior edge of the vertebral body, but did not cause clinical symptoms, and one vertebra showed cement trailing within the pedicle, but no leakage to the spinal canal was detected. The mean VAS score of the patients before surgery was 8.5, which decreased to 2.5 on the first postoperative day and 2.3 at discharge, and 2.1 at the 3-month postoperative follow-up; 12 vertebrae had significant height recovery, and the mean Cobb angle of thoracolumbar lordosis was recovered by 7o, with statistically significant differences before and after surgery (P < 0.01). Conclusions: (1) The Sky Bone Expansion System, as a percutaneous vertebral body kyphoplasty instrument, is simple, fast, safe, and can achieve good clinical results at the same time; (2) It is not an absolute contraindication for elderly patients with pathological fractures of the thoracolumbar spine, especially those with combined chronic diseases, but on the contrary, patients with chronic diseases combined with pathological fractures of the thoracolumbar segment need early activity.