ObjectiveTo study the clinical efficacy of percutaneous vertebroplasty（PVP） in the treatment of osteoporotic thoracolumbar vertebral body compression fractures combined with intravertebral clefts by improving the surgery ′s operation method. MethodsTwentysix patients with osteoporotic thoracolumbar vertebral body fracture complicated with intravertebral clefts underwent unipedicular fractional staged PVP. VAS, Oswestry Dysfunctional Index(ODI), Cobb angle, and height of the injured vertebra were evaluated preoperatively, 2 days postoperatively, and the final follow up separatively, and a comparison among three different times was made to assess the therapeutic efficacy of the improved PVP. ResultThe duration of follow up ranged from 6-12 months. The operation time ranged from 30-45 minutes, the bone cement injection volume averaged 4.5 mL (range, 3 to 7 mL). VAS, ODI, height of the injured vertebra, and Cobb angle were significantly improved after operation (P＜0.05), but no statistical difference was detected between the 2 days postoperatively and the final followup results (P＞0.05). Six bone cement leakage were recorded, with a rate of 23.1%, including 2 cases of intradiscal leakage ,2 cases of anterior vertebral leakage, 1 case of lateral leakage, and 1 case of intraspinal leakage. No spinal cord iatrogenic injury or pulmonary embolism was recorded. ConclusionUnipedicular fractional staged PVP can obviousl y decrease the thoracolumbar pain, partially relocate the fracture, improve kyphosis, and effectively attenuate the incidence of bone cement leakage, with benefits of less trauma and excellent effect

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