Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty(PVP)of thoracolumbar osteoporotic vertebral compression fracture(OVCF).Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City.Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation, they were divided into the group with adequate bone cement distribution(n=101 cases)and the group with poor bone cement distribution(n=84).Both groups underwent PVP and bilateral puncture approaches.The Visual Analogue Scale(VAS)scores of the two groups of patients before the operation, after the operation, 1 week, 3 months, and 6 months after the operation, as well as the leaving bed time of the patients,were statistically analyzed.Results A total of 185 patients were followed up for half a year after the operation.There were 101 cases in the group with adequate bone cement distribution, and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients(P>0.05), and the postoperative VAS scores of both groups were decreased compared with those before operation(P<0.05).The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week, 3 months, and 6 months after the operation were(7.17±0.76),(2.11±1.04),(1.4±0.78),(0.36±0.58) ,and(0.05±0.22), respectively,better than the poor distribution group (7.14±0.79),(2.37±0.79),(1.89±0.82),(0.68±0.76),(0.25±0.62), P<0.05.Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP.Especially when the bone cement is evenly distributed within the vertebral body, the incidence of postoperative low back pain can be reduced.