Abstract:[Objective] To introduce the surgical techniques and preliminary clinical results of percutaneous bone grafting and pedicle screw fixation for severe Kümmell's disease. [Methods] From June 2019 to June 2021, 14 patients received the abovementioned surgical pro- cedures for severe Kümmell's disease. After general anesthesia, the location of screw insertion points under fluoroscopy with body surface marks in prone position were conducted, and manual reduction of the fracture by traction and compression, the pedicle screws were placed percutaneously. The screw in the injured vertebra on one side was temporally removed, then a channel was inserted into the fissure of the fractured vertebrae over the screw tract and granular bone autografts were implanted through the channel followed by reinserting the pedicle screw. After that, the same operation was performed on the opposite side. Finally, the pedicle screw-rod system was fastened to finish the fix- ation. [Results] All patients had operations performed smoothly without serious complications with operation time of (112.6±28.2) min, and intraoperative blood loss of (131.4±77.6) ml. With time preoperatively, 1 week postoperatively and the latest follow-up, the VAS [(7.1±0.8), (3.1±0.6), (1.6±0.6), P＜0.001] and ODI scores [(75.4±4.1), (30.9±3.7), (16.0±3.5), P＜0.001] significantly decreased. In term of radiograph, all the patients had the implants in good position, with significantly improved local kyphotic Cobb angle [(29.1±4.4)°, (12.8±3.8)°, (13.6± 3.2)°, P＜0.001] and anterior vertebral height [(11.8±4.0) mm, (20.1±1.5) mm, (19.6±1.2) mm, P＜0.001] postoperatively compared with those preoperatively. [Conclusion] The percutaneous bone grafting and pedicle screw fixation are minimally invasive and technically feasible, and do effectively relieve pain, correct kyphotic deformity and restore vertebral height for severe Kümmell's disease.