Vertebral compression fractures are one of the common complications in older adults with osteoporosis, with an overall prevalence of approximately 1.23% and a female prevalence of 1.53%. In vertebral compression fractures, more than 1/3 of patients present with chronic intractable pain. The pain and spinal deformity caused by this disease can lead to decreased lung capacity, loss of appetite, sleep disturbance, and decreased activity, which leads to further bone loss, which in turn causes a further decrease in vertebral strength, making it more susceptible to fracture, resulting in a vicious cycle. Balloon-expanded vertebral kyphoplasty is a new technique in the field of spine surgery. The application of this technique in spine surgery can improve the safety of vertebroplasty surgery, reduce the complications of surgery, and become one of the important techniques in minimally invasive spine surgery. The most immediate advantage of balloon expansion is the ability to accurately control the lesion. Traditional non-balloon expansion vertebroplasty injects cement directly into the compressed vertebral body without balloon expansion, and because of the fluid nature of the cement, it will flow in the direction of lower pressure, thus risking inflow into the spinal canal to compress the spinal cord and cause paraplegia in the patient, and may even flow into the paravertebral drainage vein, leading to dangerous vascular embolism. In contrast, balloon distension kyphoplasty is performed by squeezing the balloon inside the vertebral body to reposition the vertebral body and then injecting the bone cement. This does not produce the side effect of cement spillage, and is therefore safe, reliable, efficacious and has few complications. The balloon expansion technique is mainly used for the treatment of osteoporotic vertebral compression fractures, especially in cases where conservative treatment is ineffective or pain is aggravated, and in cases where long-term bed rest is not advisable, but the vertebral body is severely compressed and the guide pin cannot be inserted and cement injected, or where the posterior edge of the vertebral body is damaged and the spinal cord is compressed. This technique is mainly used for vertebral fractures between thoracic 5 and lumbar 5, and it can be performed in two surgical routes: trans-arch and extra-arch. In the former case, for vertebral fractures between thoracic 10 and lumbar 5, the lesion is localized under X-ray, the vertebral body is punctured through the arch, the balloon is dilated, the compressed vertebral body is expanded to form a “ball” cavity with four solid walls, the balloon is removed, and bone cement is placed in the vertebral body where a space has been created. The balloon is then removed and the bone cement is placed in the space created. The latter method is suitable for vertebral fractures between thoracic 5 and 10, because the angle of inward tilt of the thoracic arch is very small, and if the former method is used, the lateral cortex of the vertebral body may be ruptured because the balloon is placed too far to the outside. Balloon expansion can effectively correct the kyphosis and restore the normal height of the compressed vertebral body, relieve and eliminate pain, and does not require major incision surgery, allowing the patient to be active immediately after surgery, which can avoid complications that may result from long-term bed rest. Patient female, 68 years old, with low back pain for 3 months, multiple vertebral compression fractures were seen preoperatively Intraoperatively, a working channel was placed in the diseased vertebral body and balloon expansion of vertebral body was performed Vertebral body was repositioned satisfactorily, and bone cement was injected into the vertebral body.