Abstract:[Objective] To investigate the clinical outcomes of robot-assisted extrapedicular percutaneous kyphoplasty (PKP) for thetreatment of osteoporotic vertebral compression fracture (OVCF). [Methods] A retrospective study was conducted on 43 patients who re-ceived extrapedicular PKP for OVCF from March 2019 to March 2022. According to the preoperative doctor-patient communication, 18cases underwent robot-assisted puncture (robot group), while other 25 cases underwent traditional fluoroscopy guided puncture (fluoroscopygroup). The perioperative, follow-up and imaging data of the two groups were compared and analyzed. [Results] Although the robot groupconsumed significantly longer operative time than the fluoroscopy group [(43.5±5.2) min vs (26.2±4.9) min, P＜0.001], the former was signifi-cantly less than the latter in term of intraoperative fluoroscopy number [(3.3±0.8) times vs (8.8±3.3) times, P＜0.001]. There were no signifi-cant differences in first puncture success rate, bone cement leakage rate, walking time and hospitalization days between the two groups (P＞0.05). The mean follow-up time was (19.8±5.7) months, and there was no significant difference between the two groups in the time to returnto full weight-bearing activities (P＞0.05). The VAS and ODI scores were significantly decreased in both groups over time (P＜0.05), whichwere not significantly different between the two groups at any corresponding time points (P＞0.05). As for imaging, there was no significantdifference in the excellence rate of bone cement distribution between the two group (P＞0.05). The local kyphotic Cobb angle and the rela-tive anterior vertebral height significantly improved postoperatively compared with those preoperatively in both groups (P＜0.05), whereaswhich proved not statistically significant between the two groups at any time points accordingly (P＞0.05). [Conclusion] Robotic navigationcan reduce the number of fluoroscopy, but increase the operation time, and can be a useful supplement to current surgical methods.