OBJECTIVE：To investigate the effects of alendronate sodium on postoperative indexes in the osteoporosis patients with thoracolumbar fracture. METHODS ：Totally 170 patients with osteoporotic thoracolumbar fracture admitted in 416 Hospital of Nuclear Industry during Jan.-Dec. 2018 were divided into control group （85 cases）and observation group （85 cases）according to random number table . All patients underwent percutaneous vertebroplasty or percutaneous kyphoplasty. After operation ，control group received symptomatic and supportive treatment. Observation group was additionally given Alendronate sodium tablets 70 mg orally，once a week ，on the basis of control group. Treatment course of 2 groups lasted for one year. VAS score ，bone metabolism indexes [serum phosphorus （P）， calcium （Ca）， osteocalcin （OST）， bone alkaline phosphatase （BAP）]， contents of osteoprotegerin（OPG）and nuclear factor-κB receptor activator ligand（RANKL），cytokines（TNF-α，IFN-γ，IL-10）levels were observed in 2 groups before and after 1，3，6，12 months of treatment，and ADR were recorded . RESULTS ：Before treatment ， there was no significant difference in VAS score ，bone metabolism indexes ，contents of OPG and RANKL and cytokines levels between 2 groups （P＞0.05）. After treatment ，VAS scores of 2 groups were significantly lower than before treatment ，the observation group was significantly lower than the control group after 1，3，6 months of treatment （P＜0.05）. OST and BAP contents of observation group after 3，6，12 months treatment as well as OPG and RANKL contents ，TNF-α and IFN-γ levels after 1，3，6，12 months of treatment were significantly lower than before treatment and control group at the same period ；IL-10 level was significantly was higher than before treatment and control group at the same period （P＜0.05）. There was no statistical significance in P or Ca of 2 groups before and after treatment ，OST，BAP，OPG，RANKL contents and cytokines levels of control group before and after treatment （P＞0.05）. There was no statistical significance in total incidence of ADR between 2 group（P＞ 0.05）. CONCLUSIONS ：Alendronate sodium can significantly relieve the pain and improve cytokines ，bone metabolism indexes ， and inhibit expression of releated pathways in osteoporosis patients with thoracolumbar fracture ，with good safety.