Objective To explore the application effect of X-ray and magnetic resonance imaging (MRI) in the treatment of patients with different types of osteoporotic thoracolumbar fracture by percutaneous kyphoplasty (PKP).

Methods A total of 136 patients with osteoporotic thoracolumbar fracture were selected as research objects, and they were divided into type Ⅰ group, type Ⅱ group and type Ⅲ group according to sagittal abnormal signal of MRI and morphological characteristics of vertebral body on X-ray lateral films. Patients in the three groups were conducted with targeted puncture PKP, and the Visual Analogue Scale (VAS) of pain, vertebral height, Oswestry Dysfunction Index (ODI) questionnaire and vertebral Cobb angle before and after operation were compared among three groups.

Results There were no significant differences in VAS scores among type Ⅰ, type Ⅱ and type Ⅲ groups at 3 days, 1 week and 6 months after surgery (P>0.05); the VAS scores at 1 week and 6 months after surgery in the three groups were significantly lower than those in the same group at 3 days after surgery (P < 0.05). At the time points of before surgery, 1 week and 6 months after surgery, the vertebral height of the type Ⅱ and type Ⅲ groups was significantly higher than that of the type Ⅰ group (P < 0.05); there was no significant difference in vertebral height between type Ⅱ and type Ⅲ groups at the time points of before surgery, 1 week and 6 months after surgery (P>0.05). There were no significant differences in the ODI index among the type Ⅰ, type Ⅱ and type Ⅲ groups at 3 days and 6 months after surgery (P>0.05); the ODI index in the three groups at 6 months after surgery was significantly lower than that in the same group at 3 days after surgery (P < 0.05). There was no significant difference in the Cobb angle of the injured vertebrae among the type Ⅰ, type Ⅱ and type Ⅲ groups at 3 days and 6 months after surgery (P>0.05).

Conclusion The X-ray and MRI show high clinical application value in evaluating the condition of patients with different types of osteoporotic thoracolumbar fracture and guiding targeted puncture PKP, and type Ⅱ and type Ⅲ patients have better clinical efficacy than type I patients.