[Objective] To investigate percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF) and possible complications caused by balloon dilation morphological differences.[Methods] A retrospective analysis was performed on 153 patients with OVCF who received PKP treatment in our hospital from January 2018 to December 2019. According to the intraoperative balloon dilation morphology, it was divided into full group and not full group. There were 103 cases in full group. There were 50 cases in the unplumped group. General information was compared between the two groups. VAS scores were compared between the two groups before and after operation and at each stage of follow-up. The course of disease, compression degree, local Cobb Angle and the number of Kummell's cases before operation were compared and analyzed between the two groups. The incidence of complications during operation and follow-up were recorded.[Results] All patients successfully completed the surgery. Postoperative VAS scores were significantly lower than those before surgery (P<0.05). There were 7 cases of bone cement leakage (6.80%) in the full group and 6 cases (12.00%) in the unfull group, with no statistical significance (P>0.05). The course of disease, compression degree, local Cobb Angle and Kummell's cases in full group were lower than those in non-full group (P<0.05), and were risk factors for incomplete balloon dilation (P<0.05). At the last follow-up, there was 1 case (0.97%) of refracture of injured vertebra in the full group and 5 cases (10.00%) in the unfull group. The rate of refracture of injured vertebra in the unfull group was significantly higher than that in the full group (P<0.05). [Conclusion] The course of disease, compression degree, local Cobb Angle and Kummell's disease are the related factors that are not conducive to balloon dilation in PKP treatment of OVCF, and incomplete balloon dilation can increase the risk of postoperative vertebral re-fracture.