Abstract:Objective To explore the correlation between sagittal imbalance of the spine and new fractures after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fracture (OVCF), providing a new idea for preventing new fracture. Methods Patients with OVCF admitted to The Affiliated Huai'an No.1 People's Hospital for PKP surgery between February 2020 and June 2023 were included in this retrospective study. Sixty-four patients with new fracture after surgery were selected as the study group, and 64 patients without new fracture were selected as the control group. The differences of sagittal spinal parameters between the two groups at 1 year after operation were analyzed and compared. Meanwhile, postoperative VAS scores, Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) of the two groups were analyzed and compared. Results The age, postoperative VAS score and ODI of the study group were significantly higher than those of the control group, while postoperative JOA score was significantly lower than that of the control group (P＜0.05). The pelvic tilt (PT) ((22.66°±2.41° vs 20.36°±3.68°,t=4.18,P＜0.01) and thoracic kyphosis (TK) (45.95°±4.87° vs 40.22°±4.22°,t=7.12,P＜0.01) of the study group were higher than those of the control group, while the sacral slope (SS) (23.44°±6.35° vs 28.47°±5.46°,t=4.81,P＜0.01), pelvic incidence (PI) (46.09°±5.57° vs 48.83°±5.46°,t=2.80,P＜0.01) and lumbar lordosis (LL) (39.06°±6.08° vs 44.30°±6.20°,t=4.83,P＜0.01) were lower than those of the control group.Conclusion Sagittal imbalance of the spine is closely related to the occurrence of new vertebral fracture after PKP in patients with OVCFs.