Objective To compare the clinical efficacy of nonsurgical and percutaneous vertebroplasty(PVP) in the treatment of fresh osteoporotic thoracolumbar fractures. Methods A total of 201 patients with osteoporotic fractures of the thoracolumbar spine from January 2016 to March 2017 in our hospital were retrospectively analyzed.Of whom 48 cases received nonsurgical treatments (conservative group) and 153 patients treated with PVP(surgery group).The treatment costs

the VAS of the two groups in 1 week

1 months

3 months

6 months and 12 months after treatment

Oswestry disability index(ODI)

vertebral body height loss and kyphotic Cobb angle in 12 months after treatment between two groups were compared. Results All patients were followed up for 12 to 21 months with an average of 13.7 months.There was no complication in the conservative group

while there was 1 case with bone cement leakage into spinal canal.The VAS score of conservative group was more than that of surgery group in 1 week and 1 month after treatment

the difference was significant（P＜0.05）.There was no significant difference in VAS score between the two groups after 3 months of treatment（P＞0.05）.The ODI scores of conservative group were more than those of surgery group after 1 week

1 months and 3 months of treatment

the differences were significant（P＜0.05）.There was no significant difference in ODI scores between the two groups after 6 months of treatment.After 12 months

the height loss rate and kyphosis of the vertebral body in the conservative group were larger than those in the surgery group

and the differences were statistically significant（P＜0.05）.The cost of treatment in the conservative group was less than that in the surgery group

the difference was statistically significant（P＜0.05）. Conclusion Non-surgical treatment can improve the pain and disability caused by osteoporotic fracture of thoracolumbar spine

with slowly relief of symptoms

lower risk and the less cost for patient compared with PVP. It is a safe and effective treatment.