OBJECTIVE: The incidence of osteoporosis complicated by vertebral compression fractures (OVCF) has been increasing annually, and percutaneous vertebroplasty (PVP) is the main surgical approach for it. It was to evaluate the use of a small needle knife (SNF) in conjunction with PVP to assess changes in inflammatory response, Th17 cell function, and magnetic resonance imaging (MRI) parameters in OVCF patients. METHODS: A retrospective analysis was conducted using the clinical data of 138 patients with OVCF, who were categorized into PVP group (n = 65) and PVP + SNF group (n = 73). MRI was employed to evaluate changes in lumbar spine anatomy and paraspinal muscle parameters. The postoperative thoracic and intercostal pain and joint function recovery were assessed. Blood samples were collected to measure inflammatory factors, Th17 cell proportions, and related cytokine levels. RESULTS: PVP + SNF group showed decreased visual analogue scale (VAS) scores at 3 days, 7 days, and 1 month postoperatively versus PVP group (P <
0.05). MRI examination indicated significant improvements in anterior vertebral height, posterior vertebra height, multifidus cross-sectional area, and erector spinae cross-sectional area, along with a decrease in steatosis proportion in the PVP + SNF group (P <
0.05). CONCLUSION: SNF in combination with PVP reduced postoperative pain and improved lumbar spine function in OVCF patients. Furthermore, it can lower inflammatory responses by enhancing Th17 cell function. MRI examinations can serve as valuable tools for predicting and assessing postoperative outcomes in OVCF patients.