Abstract:[Objective] To investigate the surgical techniques and clinical efficacy of unilateral percutaneous vertebroplasty for osteoporotic lumbar 5 vertebral compression fracture. [Methods] From November 2018 to July 2022, 47 patients with osteoporotic lumbar 5 vertebral compression fracture were treated with unilateral percutaneous vertebroplasty under local anesthesia.About 2cm from the outer edge of the pedicle surface projection of lumbar 4 vertebrae under X-ray fluoroscopy as the needle point of PVP of lumbar 5 vertebrae and the outer and upper edge of the pedicle surface projection of lumbar 5 vertebrae under X-ray fluoroscopy as the pedicle puncture point of PVP of lumbar 5 vertebrae were observed for feasibility. At the same time, the operation time, the amount of bone cement injection and bone cement leakage cases, the distribution of bone cement across the vertebral midline, the anterior edge height of lumbar 5 vertebral body before and after operation, the visual analogue scale (VAS) score before and after operation and the Oswestry disability index (ODI) were recorded to evaluate the surgical efficacy. The modified MacNab standard was used to evaluate the clinical efficacy. [Results] All incisions healed in one stage after operation. The average operation time was [(14-50)points, average 30.77 points].The amount of bone cement injected into the injured vertebral body was [(3.5-10)ml, average 5.44ml].There were 11 cases of bone cement leakage without nerve injury.?Postoperative positive X-ray film showed that the distribution of bone cement was across the midline of the vertebral body. The mean follow-up time was [(2~26)months, average 8.91 months]. The postoperative pain,lumbar function and vertebral height were significantly improved, and the differences were statistically significant (P<0.05).?The clinical efficacy of modified MacNab standard was excellent in 19 cases, good in 22 cases and fair in 6 cases, with an excellent and good rate of 87.23%.?[Conclusion] The unilateral PVP used about 2cm from the outer edge of the pedicle surface projection of lumbar 4 vertebrae as the entry point and the outer and upper edge of the pedicle surface projection of lumbar 5 vertebrae as the pedicle puncture point under X-ray fluoroscopy for the treatment of osteoporotic lumbar 5 vertebrae compression fractures is less invasive, effective, rapid recovery, fewer complications, the whole operation is smooth and the operation time is ideal. It is a minimally invasive surgical method worthy of promotion.