Objective To explore the elderly osteoporotic vertebral compression fractures in clinical treatment, leather vertebral plasty and the application effect of the protruding after vertebral plasty. Methods 90 cases of elderly patients with osteoporotic vertebral compression fractures in our hospital as the research object from September 2015 to March 2016, 90 cases were divided into two group according to treated orders in our hospital, the odd number as the control group, the even number as the observation group, 45 cases respectively, the patients in the control group with percutaneous vertebral plasty treatment, observation group patients with protruding after percutaneous vertebral plasty, compared the clinical therapeutic effect of the two groups patients. Results The observation group after treatment in patients with average height on the front of the 95.3% of the normal, and on the front of the control group after treatment in patients with 74.7% of the average height in normal, after treatment fanterior flange height observation group was obviously higher than the control group, there was significant statistically difference (P<0.05), two groups of patients after treatment at the same time the degree of pain were improved significantly (P<0.05), but the data comparison between the two groups of patients have no statistical difference (P>0.05), the other two groups of patients in the treatment of the complications in the process of no statistical difference (P>0.05). Conclusion The patients with senile osteoporosis compression fractures in clinical treatment, leather vertebral plasty and vertebral body complex vertebral plasty has very good application, and the application effect of the protruding after percutaneous vertebral plasty is better, worthy of popularization and application in clinic.