Abstract: Objective To investigate the risk factors of adjacent disc degeneration after percutaneous kyphoplasty (PKP). Methods A total of 162 PKP patients admitted to our hospital from January 2020 to September 2021 were included in the study. They were divided into the degeneration group and the control group according to the occurrence of intervertebral disc degeneration in adjacent segments during a 2-year follow-up. Univariate and Logistic multivariate regression were used to analyze the risk factors for adjacent disc degeneration, and the predictive model was constructed by Logistic regression, and the predictive efficiency was evaluated by ROC curve. Results Among the 162 patients, 25 cases (15.4%) of adjacent intervertebral disc degeneration occurred 2 years after PVP. Univariate comparison: age, proportion of smoking history, proportion of adjacent segment degeneration before surgery, bone cement injection amount, Cobb Angle immediately after surgery, vertebral height recovery rate, and bone cement leakage ratio in the degeneration group were significantly higher than those in the control group (P < 0.05), and the preoperative BMD in the degeneration group was significantly lower than that in the control group (P < 0.05). Multivariate Logistic regression analysis results: Age (OR=1.199, P=0.016), BMD (OR=0.279, P=0.035), bone cement injection volume (OR=2.653, P=0.044), and vertebral height recovery rate (OR=2.045, P < 0.001) were independent factors for the occurrence of adjacent intervertebral disc degeneration. The AUC of age, BMD, bone cement injection volume, and vertebral height recovery rate were 0.804, 0.753, 0.761, and 0.878, respectively. The prediction equation AUC based on independent factors of Logistic regression was 0.960. Conclusions Old age, low bone mineral density, large amount of bone cement injection, and excessive vertebral height recovery are risk factors for the degeneration of adjacent intervertebral discs after PKP surgery, and clinical attention should be paid to reducing the risk of degeneration.