Osteoporotic compression fracture of the thoracolumbar spine is a common and frequent disease in middle-aged and elderly orthopedics, accounting for about 2% of human fractures. It is a compression change of the vertebral body caused by increased bone fragility, bone microstructure destruction and decreased bone strength due to osteoporosis, mainly manifesting as pain in the injured vertebrae and surrounding soft tissues, usually accompanied by restricted movement, especially standing and walking. x-ray shows mostly wedge-shaped changes in the injured vertebrae, with reduced vertebral body height and mostly posterior convex deformity. Most of them are caused by non-violent factors, such as: carrying water, carrying things, bumps in a car, or even sitting on a stool. Some of the symptoms are mild and will slowly resolve with a little rest. However, most are associated with severe pain and limited movement and require treatment. The natural course of osteoporotic compression fracture is usually 8-10 weeks, and most of the pain can be significantly relieved with bed rest for about 4 weeks. It is generally considered that vertebral height loss within 50% and posterior convexity angle within 30° are stable compression fractures, while vertebral height loss of more than 50% and posterior convexity angle of more than 30° are unstable compression fractures. Most stable fractures are suitable for conservative treatment, but some have poor results with conservative treatment. Surgical treatment is usually recommended for unstable compression fractures. Surgical treatment is also generally recommended for old painful compression fractures. Conservative treatment usually lasts for 2-3 weeks in the hospital, and the methods include manual repositioning or body repositioning, medium-frequency pulse electrical stimulation, TDP physiotherapy, electroacupuncture, etc. with our in-hospital preparations for internal and external use and functional exercises. Most of the pain is significantly relieved in about 2 weeks, and then the patient is ready to be discharged from the hospital under the protection of braces. The current medical insurance policy in Chengdu has more restrictions on conservative treatment, and all the items in the above treatment methods are self-paying except for drugs and electro-acupuncture. Surgical treatment is generally minimally invasive and can be performed by percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). Both have similar outcomes, with significant pain relief immediately after surgery, and are usually discharged on the second or third postoperative day. The difference is that PKP is performed with balloon expansion followed by cement infusion, whereas PVP is performed with direct cement infusion. In contrast, PKP is a low-pressure injection of bone cement, which is relatively less risky and has a degree of vertebral body spreading and repositioning effect, while PVP is a high-pressure bone cement injection, which has a relatively higher risk of bone cement embolism and bone cement leakage. Of course, the cost of PKP is twice as high because of the use of balloons. Due to the relatively low risk, PKP is generally used in our department. Of course, there are some risks associated with the procedure, mainly the risk of puncture and the risk of cement leakage. Unstable compression fractures with neurological symptoms are usually treated with open surgery if conditions permit.