Abstract Objective To study the effect of changes in spine-pelvis parameters on the clinical outcome of percutaneous vertebroplasty in patients with OVCF. Methods From January 2014 to June 2018, 36 patients with single vertebral OVCF whose JOA score improvement rate was less than 60% after 12 months of PVP treatment were selected as the observation group. 36 patients with single vertebral OVCF who received PVP treatment during the same period were randomly selected as the control group. All patients were followed up before operation, 1 month after operation and 12 months after operation. The evaluation indexes included VAS score, JOA score, the loss rate of anterior vertebral height, Cob angle, SVA, TK, LL, PI, PT, SS. Results (1) There was no significant difference in age, sex, body mass index and injured segment between the two groups (P > 0.05). (2) The loss rate of vertebral height, Cob angle and SVA in the two groups at 1 month after operation were significantly better than those before operation (P < 0.01). (3) There were significant differences in the loss rate of the anterior vertebral height , Cob angle, SVA, TK, LL and PT between 12 months after operation and 1 month after operation in the observation group (P < 0.05), but there was no statistical significance in the control group (P > 0.05). (4) Compared with 12 months after operation, the loss rate of the anterior vertebral height , Cob angle, SVA, TK and PT in the observation group were significantly higher than those in the control group (P < 0.05), while LL and SS in the observation group were significantly lower than those in the control group (P < 0.05). (5)SVA was positively correlated with PT, while LL and SS were negatively correlated at 12 months after operation in the observation group. TK was positively correlated with LL. LL was negatively correlated with PT and SS. (6)At 12 months after operation, VAS score was positively correlated with SVA, TK and PT, negatively correlated with the decrease of LL and SS, negatively correlated with JOA score and SVA, TK and PT, and positively correlated with the decrease of LL and SS.Conclusion Although PVP could correct deformity, stabilize fracture and alleviate pain in most OVCF patients, it is necessary to pay attention to the changes of sagittal balance parameters of spine and pelvis after operation, and give support, waist circumference, crutches and other auxiliary measures to avoid complications such as re-fracture of adjacent vertebrae or chronic back pain after operation.