Aim:Osteoporotic vertebral compression fractures (OVCF) represent a significant healthcare challenge. Percutaneous vertebroplasty (PVP) and kyphoplasty are established and effective treatment modalities for OVCF. This study aims to evaluate the impact of the volume of cement injected during unilateral PVP on the occurrence of new fractures, as well as its effect on coronal balance and pain management.Material and Methods:A total of 64 patients were included in this study, which categorized them into two groups based on the amount of cement injected during the procedure. The first group comprised 34 patients with a cement volume of ≤3 cc (37 levels), while the second group included 30 patients with a cement volume of >3 cc (39 levels). Early operative and 6th postoperative month coronary balance change was recorded. The incidence and timing of new fractures following the initial vertebroplasty were recorded and analyzed.Results:No statistically significant difference was found between the two groups in terms of improvement in pre- and postoperative Visual Analog Scale (VAS) scores. Similarly, no significant difference was observed in the Cobb angle measurements between the groups. New fractures occurred in one patient (12.5%) in the first group and seven patients (87.5%) in the second group, with a statistically significant difference between the groups in terms of new fracture formation.Conclusion:A higher volume of cement injected during PVP appears to be a risk factor for the increased incidence of new fractures at other vertebral levels, with these fractures typically occurring within six months following the initial procedure. However, the volume of cement did not significantly affect clinical outcomes such as pain relief, mobility, or the restoration of coronal alignment.