BACKGROUND:Due to the puncture and difficult reduction, severe vertebral compressive fracture is considered to be the relative contraindication of vertebroplasty and kyphoplasty. OBJECTIVE:To investigate the vertebra reduction after the treatment of severe vertebral compressive fractures with percutaneous kyphoplasty. METHODS:Thirty patients (42 vertebral bodies) with severe compressive fractures were included. The compressive rate of the affected vertebral bodies was 75%-83%. The direction of percutaneous puncture was guided under digital subtraction angiography, and then postural reduction and local kyphoplasty were performed. After satisfactory reduction, bone cement was injected. RESULTS AND CONCLUSION:Al the 30 patients tolerated procedure wel . The mean height of the anterior, mid and posterior vertebral body was improved from (0.48±0.17) cm, (0.83±0.23) cm and (2.44±0.33) cm preoperatively to (0.71±0.22) cm, (1.21±0.25) cm and (2.44±0.33) cm respectively after operation. The postoperative height of the anterior, mid and posterior vertebral body was significantly higher than that before operation. The visual analogue scale score after treatment was significantly lower than that before operation. The results indicate that percutaneous kyphoplasty can ease pain, restore vertebral body height and improve quality of life of the patients with severe vertebral compressive fractures.