OBJECTIVE: To investigate the feasibility and effectiveness of selective treatment of senile osteoporotic thoracolumbar burst fractures of Denis type B with kyphoplasty and Jack vertebral dilator. METHODS: Between August 2007 and May 2011, 30 patients (32 vertebra) with osteoporotic thoracolumbar burst fractures of Denis type B were treated with kyphoplasty and Jack vertebral dilator. There were 7 males and 23 females, aged 57-85 years (mean, 76.9 years). The injured vertebrae included T11 in 2 vertebrae, T12 in 11 vertebrae, L1 in 7 vertebrae, L2 in 5 vertebrae, L3 in 3 vertebrae, and L4 in 4 vertebrae. The visual analogue scale (VAS) score, Oswestry disability index (ODI), the anterior and middle height of the vertebral body, and the Cobb angle were assessed before and after operation. RESULTS: The operation was completed smoothly in all cases; no cement leakage or intraoperative complication was found. Obvious back pain relief was achieved in all patients after operation. Thirty patients were followed up at 1 week and 6 months after operation. The VAS score was decreased from 8.2 +/- 1.3 before operation to 1.5 +/- 0.9 at 1 week after operation and 1.9 +/- 0.5 at 6 months after operation; the ODI was decreased from 82.4% +/- 15.0% to 17.8% +/- 9.5% and 23.0% +/- 8.6%; the anterior height of the vertebral body was increased from (19.5 +/- 3.2) mm to (24.8 +/- 3.0) mm and (24.0 +/- 2.6) mm; the middle height of the vertebral body was increased from (18.5 +/- 3.4) mm to (23.7 +/- 3.7) mm and (22.8 +/- 3.5) mm; the Cobb angle was decreased from (14.9 +/- 7.5)degrees to (7.6 +/- 6.0)degrees and (8.3 +/- 6.0)degrees; and there were significant differences in the VAS score, ODI, the anterior and middle height of the vertebral body, and the Cobb angle between at pre- and at post-operation (P < 0.05), but no significant difference between at 1 week and at 6 months after operation (P > 0.05). CONCLUSION: Kyphoplasty with Jack vertebral dilator for selective treatment of senile osteoporotic thoracolumbar burst fractures of Denis type B can restore the anterior and middle height of the vertebral body, correct the Cobb angle, and relieve pain, and it has good short-term effectiveness and safety.