Vertebroplasty is the treatment of osteoporotic vertebral compression fracture of commonly used method, can quickly relieve pain, maintain vertebral body height, as soon as possible to restore patients activities on fields, effectively reduce the bed of a variety of complications.But no nerve compression symptoms of osteoporotic vertebral compression fracture with segmental instability in the corresponding treatment has yet to form a consensus. this paper reported one case of L4, L5 vertebral compression fractures of osteoporosis combined L4-5 cases of segmental instability with symptoms after conservative treatment in bed not ease,Total body bone loss was rapid,osteoporotic vertebral compression fracture occcurred in L1 with slight activity,L1percutaneous vertebroplasty and perfusion bone cement screw internal fixation combined with posterolateral fusion in the lower lumbar spine were performed,and the movement was resumed in the short term after surgery, and the follow-up results were good.The report is as follows: