BACKGROUND: There are differences between unilateral and bilateral percutaneous kyphoplasty for the treatment of osteoporotic compression fractures.
OBJECTIVE: To evaluate the efficacy difference of unilateral versus bilateral percutaneous kyphoplasty for the treatment of osteoporotic compression fractures.
METHODS: The patients with osteoporotic compression fractures were randomly divided into unilateral and bilateral puncture group. Patients underwent unilateral or bilateral kyphoplasty with bone cement. The X-ray film of lateral spinal was taken during follow-up. The changes of anterior, middle and posterior vertebral body height and the convex angle were measured. The pain visual analogue score was used to determine the relief of low back pain, and the oswestry functional disability index was used to assess the quality of life. A follow-up of 12-36 months was preformed with an average of 26.3 months. 
RESULTS AND CONCLUSION: The mean operation time, the mean volume of cement injected into one level and the times of intraoperative fluoroscopy of unilateral group was lower than that of bilateral group (P < 0.05). There were significant difference in pain visual analogue score, Cobb’s angle, oswestry functional disability index and the anterior, middle and posterior vertebral body height in two groups before puncture. Unilateral kyphoplasty for osteoporotic compression fractures is effective similar to bilateral kyphoplasty. But less time, fluoroscopy and cement were the advantage of unilateral kyphoplasty.