Elderly patients with vertebral compression fractures miss the early stages of osteoporotic fractures, that is, within 3 weeks of the fracture, for various reasons. Some will be left with low back pain. This pain does not diminish over time and in some cases tends to worsen. With an aging population, this type of patient has become more common in recent years. In this group of patients, we must first determine whether the low back pain in the elderly is related to an old fracture. The criteria for determining this are localized percussion pain and x-ray film in hyperextension and hyperflexion position. If both are positive. It can be determined that the low back pain is related to a fracture. In these patients, the opportunity for conservative treatment has been lost and the only treatment is minimally invasive percutaneous vertebroplasty. The surgery can relieve the pain caused by the fracture, and combined with postoperative functional exercise, it can restore the elderly patient’s motor ability and improve the quality of life.