Abstract:[Objective] To compare the early results of general and local anesthesia for percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar osteoporotic fractures. [Methods] A retrospective study was conducted on 104 patients who received PKP for thoracolumbar osteoporotic fractures in our hospital from September 2022 to October 2023. According to preoperative doctor-patient communication, 51 patients had PKP performed under general anesthesia (GA), while other 53 patients were under local anesthesia (LA). The clinical and imaging data during hospitalization were compared between the two groups. [Results] The GA group proved significantly superior to the LA group in terms of operation time [(42.2±2.7 min) vs (53.6± 4.1) min, P＜0.001], fluoroscopy times [(25.7±6.3) vs (32.4±9.6), P＜0.001] and Kolcaba comfort score [(83.4 ± 8.6) vs (74.7 ± 8.1), P＜0.001], whereas the former resumed walking significantly later than the latter [(29.5±5.5) hours vs (26.6±3.4) hours, P=0.002]. There was no statistically significant difference in the incidence of early adverse reactions between the two groups (P＞0.05). Regarding imaging, the anterior vertebral height (AVH) and local kyphotic angle (LKA) were significantly improved postoperatively in both groups compared with those preoperatively (P＜0.05). At the discharge, the GA group was significantly superior to the LA group in terms of AVH [(23.5±1.3) mm vs (20.1±1.1) mm, P＜0.001] and LKA [(7.2±1.7)° vs (9.3±1.8)°, P＜0.001]. [Conclusion] Compared with under local anesthesia, the PKP under general anesthesia does indeed reduce the operation time and radiation exposure, reconstruct the vertebral body better with considerably better comfort level.