Eighty-nine patients with single-segment osteoporotic vertebral compression fractures (OVCFs) were randomized to receive either percutaneous curved kyphoplasty (PCKP; n=43) or unilateral percutaneous vertebral kyphoplasty (UPKP; n=46). The primary outcome was pain relief as measured by visual analog scale (VAS) scores, while secondary outcomes included functional improvement (Oswestry Disability Index [ODI]), cement distribution, cement leakage rate, and vertebral height restoration. Outcomes were assessed preoperatively and at 2 days, 3 months, and 12 months postoperatively. Overall, the results of the study revealed that PCKP achieved significantly better pain relief at 2 days post-surgery, improved cement distribution, and a lower cement leakage rate compared to UPKP. However, at 3 and 12 months, the outcomes converged with no significant differences in VAS, ODI, or vertebral height recovery. This suggests that while both procedures are effective for OVCFs, PCKP offers early advantages in cement handling and pain control, particularly in patients with moderate to severe compression.