Objective To study the clinical effect of percutaneous kyphoplasty (PCVP) and traditional unilateral and bilateral percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods 126 patients with OVCF in our hospital from December 2018 to December 2020 were selected and randomly divided into three groups, group A (42 cases, treated with traditional bilateral PVP operation), group B (42 cases, treated with traditional unilateral PVP operation) and group C (42 cases, treated with PCVP operation). The operative time, blood loss, intraoperative fluoroscopy times, bone cement injection volume, postoperative hospital stay, excellent and good rate of bone cement distribution and leakage rate of the three groups were recorded. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were used to evaluate the pain and the improvement of lumbar function before operation and 1,12 weeks after operation. The relative height of injured vertebrae before operation and at 1 and 12 weeks after operation were compared among the three groups, and the recovery rate of Cobb angle at 1 and 12 weeks after operation were compared among the three groups. Results There was no significant difference in postoperative hospital stay and bone cement leakage rate among the three groups (P＞0.05). The operative time of group A was significantly longer than that of group B and C (P＜0.05), and the amount of blood loss, intraoperative fluoroscopy and bone cement injection in group A were significantly higher than those in group B and C (P＜0.05), while there was no statistical significance in the operative time, blood loss, intraoperative fluoroscopy and bone cement injection in group B and C (P＞0.05). VAS score and ODI index of the three groups at 1 and 12 weeks after surgery were significantly lower than those before surgery (P＜0.05). There was no significant difference in VAS score and ODI index among the three groups before and 1 and 12 weeks after operation (P＞0.05). The relative height of injured vertebrae 1 and 12 weeks after operation in three groups was significantly higher than that before operation (P＜0.05). There was no statistically significant difference in the relative height of injured vertebrae among the three groups before and 1 and 12 weeks after surgery (P＞0.05), and there was no statistically significant difference in the recovery rate of injured vertebrae Cobb Angle 1and 12 weeks after surgery (P＞0.05). Conclusion The clinical efficacy of PCVP in the treatment of OVCF is reliable. At the same time, it has the advantages of short operation time of traditional unilateral PVP, fewer intraoperative fluoroscopy times, lower intraoperative blood loss and bone cement injection volume, as well as ideal bone cement distribution of traditional bilateral PVP, and can strengthen the target vertebral body uniformly to ensure the stability of fractured vertebral body and spine.