In modern society, with the aging of the population, osteoporosis is very common, and osteoporotic fractures in various parts of the body are occurring more and more frequently, and thoracolumbar compression fracture is one of the more common ones, which seriously threatens the health of middle-aged and elderly people. After the fracture occurs, the problem in front of patients and their families is how to treat it, should they choose conservative treatment? Or is surgery better? Let’s take a look at the following two real cases: 58-year-old Ms. Wang, 3 years ago, after moving heavy things, she had severe pain in her lower back and was unable to move, so she took a film at the hospital near her home and showed a compression fracture of the 12th thoracic vertebra. Although the pain symptoms were less than when she was injured, the pain in her lower back was always present, sometimes light and sometimes heavy, and she felt that she could not straighten her lower back and did not dare to use her strength. Later, the patient was referred to our department. Based on the high signal of edema in the 12th thoracic vertebra shown on the MRI, we performed a vertebroplasty under local anesthesia, in which bone cement was injected into the 12th thoracic vertebra. The next day after the surgery, Ms. Wang felt no pain in her lower back and was able to straighten her waist. In her own words, she felt that she had a backbone and the problem that had been bothering her for 3 years was finally solved. Ms. Zhao, 62, fell down in the shower, causing severe pain in her lower back and preventing her from moving. A film taken at a nearby hospital showed a compression fracture of the 1st lumbar vertebra, and the doctor told her that she could recover after 3 months of recuperation in bed. However, because her daughter was going to have a baby in a month, Ms. Zhao did not want to stay in bed for 3 months anyway! The patient was admitted to our department, and we also performed a vertebroplasty under local anesthesia and injected bone cement into the 1st lumbar vertebra. After coming out of the operating room, Ms. Zhao felt less pain in her lower back and was able to go down with her lumbar brace the next day. A month later her daughter gave birth to a child, and Ms. Zhao had her family send her wedding candy and eggs for us to share her joy. There are many more patients with osteoporotic thoracolumbar compression fractures who have been cured by vertebroplasty, and the above are two of the most common cases, but they are more representative and illustrative because of the trouble they went through in seeking medical treatment. Compression fractures of the thoracic and lumbar spine can be caused by minor trauma in the elderly with a decrease in bone quality throughout the body, which is becoming more and more common in orthopedic clinics and very difficult to treat. Traditional treatment methods are long-term bed rest, medication and bracing, but these methods cannot effectively relieve the pain symptoms, and long-term bed rest further aggravates the osteoporosis and makes it easier to develop complications such as infection, thrombosis and reduced cardiopulmonary function, which brings heavy burden of care to the family; while surgical internal fixation treatment is easy to fail due to the poor screw holding power of osteoporosis, and most patients are physically Even with surgical internal fixation, the patient cannot move to the ground early because of the long waiting time for fracture healing and pain, so it is not superior to non-surgical treatment, so it is rarely used clinically. Vertebroplasty was first proposed and started to be used by a French scholar named Calibert in 1987, and has been rapidly developed and applied in orthopedics in the last decade, and is now gradually regarded as the treatment of choice for vertebral compression fractures caused by osteoporosis. It is a truly minimally invasive technique for the spine, using percutaneous puncture to inject bone cement into the compressed vertebral body through the vertebral arch, thereby stabilizing the vertebral body and strengthening it, while restoring the height of the vertebral body, relieving or eliminating vertebral pain, and enabling the patient to recover early and be able to get out of bed. After vertebroplasty, the patient’s pain can be significantly reduced or disappeared immediately, which has an immediate effect and significantly improves the patient’s quality of life, and has the advantages of easy and simple operation, less trauma, less pain, and early movement of the patient to the ground. In addition to osteoporotic vertebral compression fractures, vertebroplasty can also be applied to vertebral hemangiomas, myeloma, osteolytic metastases, primary malignant tumors of the vertebral body, etc. We use vertebroplasty to treat osteoporotic vertebral fractures in the elderly, and our surgical experience is as follows: preoperative CT scan examination to understand whether the posterior wall of the affected vertebra is intact, and if there is a fracture in the posterior wall, vertebroplasty is not considered to avoid nerve damage caused by cement infiltration into the spinal canal to ensure the safety of the operation; when the elderly often have more than two vertebral fractures at the same time, the vertebra with obvious compression on the X-ray is not necessarily the The “responsible vertebra” for the pain is not always the “responsible vertebra”, and since the percussion pain of the affected vertebra is not obvious in some patients and the performance of the pain site is different, how to determine the “responsible vertebra” is the key to ensure the efficacy of the surgery, so it is necessary to use MRI. If a high edema signal is found in a vertebral body, the vertebral body can be identified as the “responsible vertebra” for the pain.