To investigate the clinical efficacy of Zhuanggu Decoction combined with percutaneous kyphoplasty (PKP) in the treatment of elderly osteoporotic spinal compression fracture,analyze its effects on bone metabolism indexes of patients.Methods:A total of 66 patients with elderly osteoporotic spinal compression fracture who were treated in Qionghai Hospital of Traditional Chinese Medicine from September 2016 to February 2018 were selected.All patients were divided into a control group (n=28) and an observation group (n=38) according to different treatment methods.Patients in the 2 groups were treated with PKP,and the observation group added Zhuanggu Decoction after surgery and took 1 month continuously.The clinical efficacy,fracture healing and recovery of lumbar function were compared between the 2 groups after treatment.The changes of bone metabolism indexes levels were detected and compared before and after treatment.Results:The total effective rate was 94.74% in the observation group,which was higher than 89.29% in the control group (P>0.05).Compared with before treatment,the height of anterior margin of the injured significantly rose in the 2 groups after treatment,vertebral wedge angle and Cobb angle significantly decreased,and the difference between the 2 groups was significant (P<0.05).After treatment,the levels of bone metabolism markers such as BMD,serum BGP,BALP and JOA scores significantly increased in the 2 groups after treatment,and the observation group was significantly higher than those of the control group (P<0.05).Conclusion:Zhuanggu Decoction combined with PKP in the treatment of elderly osteoporotic spinal compression fracture can significantly inhibit bone loss,improve bone metabolism,promote fracture healing,improve clinical symptoms and overall treatment efficacy.