Objective To observe medium and long-term quality of life of non-surgical treatment and vertebral plasty in patients with osteoporotic vertebral compression fractures. Methods A retrospective study was performed. A total of 108 patients with osteoporotic vertebral compression fractures, who were hospitalized in Guangdong Provincial Hospital of TCM from January 2006 to December 2006, were selected, including 55 patients with non-operative treatment and 53 patients received vertebral plasty. A SF-36 scale and VAS scale were used, in order to compare the quality of life after non-operative treatment or vertebral plasty for more than 3 years after the treatment. The incidence of re fractures was observed. Results The average follow-up was 50. 59 months (36-69 months). According to the SF-36 scale, the physiological function, physical functioning, and role-emotional were better in non-surgical group than those in vertebral plasty group (P < 0. 05). In other dimensions, no significant difference was observed. The VAS score in non-surgical group was also better than that in vertebral plasty group (P < 0. 05 ). Conclusion Considering the medium and long-term quality of life and pain relief, the efficacy in non-surgical treatment group is superior to that in the vertebral plasty group, and the incidence of re fractures is much lower, which indicates that strictly observing the surgical indication is important in clinical work. [ABSTRACT FROM AUTHOR]