Objective To research the efficacy and safety of percutaneous puncture kyphoplasty in the treatment of elderly osteoporotic vertebral fracture.Methods PkP were performed in 23 patients(34 vertebrae),visual analogue scale(VAS)and mobility were evaluated before and three days after operation.Relief of back pain,recovery of mobility and complications(cement leakage,adjacent vertebral body fractures,etc)were observed in the follow up.Results All patients were successfully performed with immediate relief of their back pain.The mean scores of VAS and mobility 3 days after operation were respectively decreased from(7.5 ±0.7),(2.4 ±0.6)preoperative to(2.5 ±0.6),(1.2 ±0.4)at 3 day after operation with a significant difference(t= 23.8,13.4,P ＜0.01).The patients were followed up for average 15.6 months with satisfactory therapeutic effect,one patient died of heart disease two months after discharge,around vertebral fracture occurred in 4 patients,they were no cement leakage in all the patients.Conclusion PKP is one of the new minimally invasive technologies,which can rapidly relieve pain.PKP is an ideal method in treating elderly osteoporotic spinal compression fractures.