Objective: To compare the clinical efficacy of percutaneous vertebroplasty (PVP) by puncturing in the cyst and PVP by puncturing through the cyst wall in the treatment of stage Ⅰ and Ⅱ Kummell's disease. Method: The clinical data of 56 patients with stage Ⅰ and Ⅱ Kummell's disease who underwent PVP in our department from March 2017 to February 2021 were retrospectively analyzed. The patients were divided into two groups according to the surgical puncture method: The patients treated with PVP by puncturing through the cyst wall was group A (n=30); Patients treated with PVP by puncturing in the cyst wall was group B (n=26). Perioperative, follow-up and imaging data were compared between the two groups. Results: All patients successfully completed the operation and were followed up for 12-24 months (mean 17.4 months). There was no statistically significant difference in the operation time, the success rate of first and leakage rate of bone cement between two groups (P>0.05), but there was statistically significant difference in the number of fluoroscopy, puncture and amount of bone cement injection (P < 0.05). VAS score and ODI score of two groups were significantly improved at 3 days after surgery and the last follow-up compared with preoperative results (P < 0.05), and there was no increasing trend over time. Compared with the two groups, there were no significant differences in VAS score and ODI score at 3 days after surgery and the last follow-up (P > 0.05). Cobb angle, anterior edge height and midline height of injured vertebra were significantly improved at 3 days after surgery and the last follow-up (P < 0.05). There was no long-term vertebral refracture in the group B, and there were 2 cases in the group A. Conclusions: The clinical efficacy of PVP by puncturing through the cyst wall in the treatment of stage Ⅰ and Ⅱ Kummell's disease is significant. The long-term effect of this method is stable and can effectively reduce the risk of vertebral refracture.