Abstract： Objective： To observe the effect of Zuogui Pills combined with Zoledronic Acid on postoperative functional recovery and osteoprotegerin （OPG） in patients with osteoporotic vertebral compression fractures （OVCF） undergoing percutaneous vertebro plasty （PVP） surgery．Methods：A total of 120 patients with OVCF who received treatment at Nanyang Central Hospital from January 2022 to January 202 were selected as the research subjects and divided into the western medicine group and the Chinese medicine group，with 60 cases in each group，using a random number table method． The western medicine group received conventional treatment combined with Zoledronic Acid treatment，and the Chinese medicine group received additional treatment with Zuogui Pills on the basis of the treatment of the western medicine group． Compared the therapeutic efficacy of the two groups， compared the changes in traditional Chinese medicine symptom scores，Oswestry Disability Index （ODI） scores，Visual Analogue Scale （VAS） for pain， bone metabolism indicators [typeⅠprocollagen N-terminal peptide （PⅠNP）， typeⅠcollagen C-terminal peptide （CTX- Ⅰ）， and parathyroid hormone （PTH）]， inflammatory factors [C-reactive protein （CRP）， tumor necrosis factor- α （TNF- α）， and interleukin-10 （IL-10）] levels， serum OPG and bone morphogenetic protein- 2（ BMP-2） levels before and after treatment．Results：The clinical effect in the Chinese medicine group was superior to that of the western medicine group，the difference being significant （P＜0.05）．After treatment，the VAS，ODI， and traditional Chinese medicine symptom scores in both groups were decreased when compared with those before treatment （P＜0.05），and the VAS，ODI and traditional Chinese medicine symptom scores in the Chinese medicine group were lower than those in the western medicine group （P＜0.05）．After treatment，the levels of PTH and CTX-Ⅰ in both groups were decreased when compared with those before treatment （P＜0.05）， and the PⅠNP levels were increased when compared with those before treatment （P＜0.05）； the levels of PTH and CTX- Ⅰ in the Chinese medicine group were lower than those in the western medicine group （P＜0.05），and the PⅠNP level was higher than that in the western medicine group （P＜0.05）． After treatment， the levels of CRP， TNF-α， and IL-10 in both groups were decreased when compared with those before treatment （P＜0.05），and the levels of CRP，TNF-α，and IL-10 in the Chinese medicine group were lower than those in the western medicine group （P＜0.05）．After treatment， the levels of serum OPG and BMP-2 in both groups were increased when compared with those before treatment （P＜ 0.05），and the levels of serum OPG and BMP-2 in the Chinese medicine group were higher than those in the western medicine group（ P＜0.05）．Conclusion：The combination of Zuogui Pills and Zoledronic Acid has a positive effect on the functional recovery of OVCF patients after PVP surgery， effectively inhibiting bone resorption and promoting postoperative bone formation.