Aim:The purpose of this study is to investigate the incidence of new compression and to analyze factors that influence the fractures in adjacent levels after percutaneous vertebroplaty (PVP).Material and Methods:This retrospective study examined 206 patients who had undergone PVP for single level osteoporotic compression fractures during the last seven years in our department. After PVP, the patients were observed for at least over one year, and 29 patients showed new additional compression fractures in adjacent levels. One hundred seventy seven patients who did not show additional compression fractures were analyzed as the control group. Results:The statistically significant factors that influence new compression fractures in adjacent levels after PVP were as follows: being female, initial thoracolumbar junction fracture, preoperative large kyphotic, preoperative large wedge angle, change in wedge angle, administration of BPP in osteopenia group, and intradiscal cement leakage.Conclusion:This study identified many factors that influence newly developed compression fractures in adjacent levels after PVP. Interestingly, the administration of BPP in osteopenia group had positive influence on new fractures in this study. Therefore, we recommend early administration of BPP to patients with osteopenia.