Background: A small but significant proportion of patients experienced residual back pain after PVP or PKP treatment. The aim of the present study was to explore risk factors that may affect residual back pain after PKP or PVP. This study identified the risk factors of residual back pain after PKP or PVP, allowing proper intervention and improved clinical outcome.Methods: From January 2010 to January 2017, a total of 853 patients were treated by PVP or PKP at The First Affiliated Hospital of

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... an Jiaotong University. We recorded the Visual Analog Scale (VAS) scores. Patients with a VAS score > 3 post-operatively and at the 1 month follow-up evaluation were grouped into the "residual back pain" group. The others were grouped into the control group. The following possible risk factors were collected: age; gender; weight; bone mineral density (BMD); surgical approach; surgical type; cement distribution; anesthesia; hypertension; diabetes; smoking; alcohol consumption; vertebral fracture type, and vertebral fracture location. Risk factors associated with residual back pain were evaluated using logistic regression analysis.Results: The incidence of residual back pain after PVP/PKP is 9.61%. Results showed that cement distribution, smoking, vertebral fracture type and vertebral fracture location were independently associated with residual back pain after PVP or PKP in the early post-operative stage. Conclusion: Unsatisfactory cement distribution, smoking history, osteogenic vertebral tumors, osteolytic vertebral tumors, and thoracic fractures were independently associated with residual back pain after PVP or PKP at the early post-operative stage.