[Objective] To compare whether manipulative reduction is participated in bone filling mesh container in the treatment of osteoporotic vertebral compressibility fracture (OVCF). [Methods] A retrospective analysis was conducted on 67 patients treated with bone filling mesh container from July 2020 to April 2022. They were divided into manipulative reduction participation group and non manipulative reduction group according to different treatment methods. Record and compare perioperative data and follow-up status, including Visual Analogue Scale and Oswestry Disability Index. Record and compare Cobb angle, anterior vertebral height, and their changes, as well as other complications. [Results] All patients underwent surgery successfully without any serious complications. The surgical operation time and bone cement leakage rate of the reduction group were significantly better than those of the non reduction group (P<0.05), and there was no statistically significant difference in intraoperative fluoroscopy frequency and bone cement volume between the two groups (P>0.05); There was a statistically significant difference in VAS score and ODI index between the two groups before and after surgery (P<0.001), while there was no statistically significant difference between the groups (P>0.05); There was a significant difference in Cobb angle and anterior edge height between the two groups before and after surgery (P<0.05), while there was no statistically significant difference between the groups (P>0.05). However, there was a significant difference in the degree of change in Cobb angle and anterior edge height between the two groups before and after surgery (P<0.05). [Conclusion] In the treatment of osteoporotic vertebral compressibility fractures, bone packing mesh container combined with manipulative reduction can better reduce the rate of bone cement leakage, shorten the operation time, and improve the Cobb angle and the height of the anterior edge of the vertebral body.