Abstract: Objective: To investigate and compare the efficacy and neurological function of expanded pedicle screw fixation (EPSF) and percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fracture. Methods: 102 patients admitted to our orthopedic department were collected. According to the treatment methods, the patients were divided into EPSF group (51 cases) and PKP group (51 cases). The pain, back function, quality of life and nerve function of the patients in 2 groups were compared before operation, 1 week and 4 weeks after operation. The therapeutic effect was recorded 3 months after operation. Results: The amount of bleeding and the length of operation were comparable between 2 groups (P > 0.05). Compared with the EPSF group, the operation time of PKP was significantly reduced (P < 0.05), the visual analog scale (VAS), Oswestry disability index (ODI), the MOS item short from health survey(SF-36), National institute of health stroke scale (NIHSS) were significantly increased (P < 0.05) in the PKP group. Compared with the EPSF group, the total effective rate of PKP group was significantly higher than that of EPSF group (P < 0.05). Conclusion: Compared with EpsF, PKP has some advantages in treating the osteoporotic vertebral compression fracture, which is helpful to improve the curative effect and neurological function.