To evaluate the effect of vertebroplasty with a bone filler device compared with balloon kyphoplasty. A total of 222 patients underwent operations from January 2008 to October 2012. One-level fractures numbered 169 (86.7 %) cases and two-level fractures numbered 26 (13.3 %). A total of 221 vertebral levels were analyzed consequently. Vertebral height, compression ratio, and segmental Cobb’s angle were measured in preoperative and postoperative lateral X-rays. The compression ratio was the most influential parameter among three variables. Adjusted postoperative compression ratio was not significantly different between two operation groups. Bone cement leakage rates did not differ (p < 0.05). Bone cement distribution was spongy type in the majority of the vertebroplasty with bone filler device (94.5 %), but only in 42.0 % of the kyphoplasty. High bone densitometry readings and long period from diagnosis to operation were significant risk factors for bone cement leakage. Vertebroplasty with a bone filler device could achieve equivalent compression reduction and bone cement leakage rate, as well as greater sponge-type bone cement distribution, which were advantages over balloon kyphoplasty.