Objective To investigate the efficacy of Schanz nail temporary reduction combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF) with poor posture reduction, so as to find a more effective surgical method to correct kyphosis. Methods The clinical data of 45 OVCF patients with poor postural reduction admitted to Beijing Changping Hospital from January 2019 to December 2020 were retrospectively analyzed, the patients were divided into the group A (routine PKP, 23 cases) and the group B (transcutaneous Schanz nail temporary reduction combined with PKP, 22 cases) according to different treatment methods. The operation related indexes, Oswestry Dysfunction Index (ODI), pain Visual Analog Scale (VAS) score, Cobb angle and anterior vertebral height, postoperative related complications and the occurrence of secondary fracture of injured vertebral body were compared between the two groups. Results The operation time of the group B was significantly longer than that of the group A, and the intraoperative blood loss and bone cement injection amount were significantly more than those of the group A; compared with before operation, the scores of ODI and VAS in the two groups decreased significantly 6 months after operation, the Cobb angle in the two groups 6 months after operation decreased singnificantly, and the group B was significantly lower than the group A, the height of anterior edge of vertebral body all increased significantly, and the group B was significantly higher than the group A (all P<0.05); there was no significant difference between the two groups in the incidence of bone cement leakage, adjacent vertebral fracture and secondary fracture of injured vertebral body (all P>0.05). Conclusion The combination of Schanz nail temporary reduction with PKP has a significant effect in the treatment of OVCF with poor posture reduction, which can effectively correct kyphosis, restore vertebral height, reduce postoperative pain, accelerate recovery of injured vertebral function, and reduce the occurrence of injured vertebral re-fracture, security is good.