Abstract：Objective：To observe the effect of Diyu Shengsui Decoction combined with Zoledronic Acid on bone metabolism and lumbar functional recovery in patients with percutaneous kyphoplasty (PKP). Methods：A total of 80 cases of patients who had osteoporotic vertebral compression fractures (OVCF) and underwent PKP were randomly divided into the control group and the trial group， with 40 cases in each group. The control group was treated with Zoledronic Acid，and the trial group was additionally treated with Diyu Shengsui Decoction based on the treatment of the control group. The Cobb angle of the injured vertebra， bone density， and bone metabolism indicators [Ca2+ ， β-CrossLaps (β-CTX) and bone alkaline phosphatase (BALP)]，bone healing indicators [insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF)]， and Oswestry Dysfunction Index (ODI) were compared between the two groups before treatment and after three months of treatment. The recurrence rates of fractures within one year after the end of treatment were compared between the two groups. Results： After treatment， the Cobb angle of the injured vertebra in the two groups was decreased when compared with that before treatment (P＜0.05)， and bone density was increased when compared with that before treatment (P＜0.05)； the Cobb angle of the injured vertebra in the trial group was smaller than that in the control group (P＜0.05)，and bone density in the trial group was larger than that in the control group (P＜0.05). After treatment，the levels of Ca2+ and BALP in the two groups were increased when compared with those before treatment (P＜0.05)， and the levels of β-CTX were decreased when compared with those before treatment (P＜0.05)；the levels of Ca2+ and BALP in the trial group were higher than those in the control group (P＜0.05)，and the level of β-CTX in the trial group was lower than that in the control group (P＜0.05). After treatment， IGF-1 and VEGF in the two groups were increased when compared with those before treatment (P＜0.05)， and the two indicators in the trial group were higher than those in the control group (P＜0.05). After treatment，ODI scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and the ODI score in the trial group was lower than that in the control group (P＜0.05). Within one year after treatment，the recurrence rate of vertebral fractures was 2.50% in the trial group and 7.50% in the control group， there being no significance in the difference (P＞0.05). Conclusion： The application of Diyu Shengsui Decoction combined with Zoledronic Acid in the treatment of OVCF patients after PKP surgery can decrease the Cobb angle of the injured vertebra， increase bone density， and effectively improve bone metabolism，bone healing indicators，and lumbar function.