Objective To investigate the factors influencing the persistence of residual low back pain following percutaneous vertebroplasty （PVP） in patients with osteoporotic vertebral fractures （OVF）， in order to provide a scientific basis for clinical intervention strategies. Methods A retrospective analysis was conducted on data from 1 120 patients diagnosed with OVF who received PVP treatment between July 2020 and June 2025. Among them， 61 patients who experienced residual low back pain in the early postoperative period （defined as 2 days to 1 month after surgery） with a postoperative visual analog scale （VAS） score greater than 3 points were selected as the observation group. An additional 61 control subjects were matched to the observation group at a 1∶1 ratio based on age （± 5 years）， gender， and preoperative bone mineral density （± 0.5 standard deviation）. Univariate and logistic regression analyses were subsequently performed to evaluate potential influencing factors. Results Univariate analysis revealed statistically significant differences between the two groups with respect to preoperative thoracolumbar fascia injury （TFI）， MRI-detected liquefaction signals in the affected vertebrae， the number of involved vertebrae （≥ 2）， and suboptimal bone cement distribution （P < 0.05）. Multivariate regression analysis confirmed that these factors were independent risk factors， with corresponding odds ratios （ORs） of 5.378， 6.111， 3.245， and 2.890 （all P < 0.05）. The area under the curve （AUC） of the predictive model was 0.929， indicating a high level of predictive accuracy. Conclusion Preoperative TFI， MRI-demonstrated liquefaction signals in the affected vertebrae， the presence of multiple responsible vertebrae， and suboptimal bone cement distribution may contribute to an increased risk of early residual low back pain following PVP.