Objectives: To investigate the efficacy of thoracolumbar morphology and different surgical methods on the treatment of single segment osteoporotic thoracolumbar compression fracture. Methods: We retrospectively collected patients with osteoporotic thoracolumbar compression fracture who was performed percutaneous kyphoplasty (PKP)/percutaneous vertebroplasty (PVP) in the orthopedics department of our hospital from January 2012 to June 2016. Furthermore, the subjects were classified into non-thoracic Junctional Kyphosis group (Non-TJK group) according to the size of preoperative thoracoluminal kyphosis angle (preoperative T10-L2<20°) and thoracic Junctional Kyphosis Group (TJK group; preoperative T10-L2 20° or higher), and the sagittal parameters and clinical efficacy were evaluated and compared. Results: We included 65 patients in the study (21 males and 44 females), with an average age of 62.87±5.58 years and an average follow-up time of 14.32±2.01 months. The wedge angle (24.68°±2.51° vs 15.08°±1.27°, P<0.001), TLK (26.08°±2.36° vs 15.25°±1.46°, P<0.001) and SVA (31.92°±5.41° vs 25.25°±1.84°, P<0.001) in TJK group were significantly higher than those in non-TJK group. At the final follow-up, the wedge angle, TLK and SVA of TJK group were still larger than those of non-TJK group. The VAS score and ODI score of the two groups were significantly improved postoperatively, but the value in TJK group was larger than that of non-TJK group with statistical difference. At the final follow-up, the wedge angle (9.40°±2.63° vs 6.90°±1.16°, P<0.001) and TLK (9.77°±3.25° vs 7.90°±1.21°, P<0.001) of PVP group were significantly higher than those of PKP group, and the long-term efficacy was slightly worse than that of PKP group. Conclusion: It is more likely to cause long-term residual back pain symptoms if the preoperative TLK is too large. PKP is better than PVP in restoring the shape of vertebral body, reducing the local kyphosis angle, and has more advantages in the long-term efficacy.