Abstract: Objective: Describes surgical and therapeutic techniques and preliminary clinical results of percutaneous bone grafting and vertebral arch nail fixation for severe Kümmell's disease. Methods: From June 2019 to June 2021, 14 patients with severe Kummell's disease were treated with percutaneous bone grafting and vertebral arch nail fixation. After general anesthesia, the patients were placed in the prone position, the nail entry point was located by fluoroscopy, the surface mark was made, and traction compression was performed to assist reduction. Routine disinfection and sterile towels. After standard percutaneous screw placement, the screw on one side of the injured vertebra was rotated out first, and then inserted into the bone grafting funnel through the screw path with the guide needle. Bone particles are driven into the fissure through the bone grafting funnel with a bone grafting rod, and fluoroscopy was continuously monitored during the operation. When the bone particles are filled satisfactorily, exit the funnel, screw in the screw, and repeat the above operation on the opposite side. After bone grafting, the pre-bent titanium rod was connected, the screw plug was tightened, the tail arm was broken, and the incision was sutured after washing. Results: All patients successfully completed the operation without serious complications. The operation time was (112.64±28.15) min, and the intraoperative blood loss was (131.43±77.64) ml. The patients were followed up for 13 to 20 months, VAS and ODI scores were significantly decreased at 1 week after operation and at last follow-up (P<0.05). The image showed that the internal fixation was in good position, the kyphosis Cobb Angle of the injured vertebrae was significantly reduced and the anterior edge height was significantly restored at 1 week after operation and last follow-up(P<0.05). Conclusions: Percutaneous bone grafting and vertebral arch nail fixation in the treatment of severe Kummell's disease can effectively relieve pain, correct kyphosis, and restore vertebral height, with less trauma and bleeding, and the clinical effect is satisfactory.