Objective To explore the feasibility of utilizing spinal surgery robots in percutaneous kyphoplasty (PKP). Methods Patients with thoracolumbar osteoporotic vertebral compression fracture (OVCF) who were admitted to the First People’s Hospital of Shuangliu District, Chengdu between June 2022 and June 2024 were selected. The enrolled patients were randomly divided into a robot-assisted group and a manual group in a 1∶1 ratio. The fractured vertebral height, Cobb angle, Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI), and complications were compared between the two groups on postoperative day 1 and at 6 months postoperatively. The degree of puncture deviation, bone cement distribution and leakage on postoperative day 1, as well as Odom’s criteria scores at 6 months postoperatively, were also compared between the two groups. Results A total of 130 patients were enrolled, with 65 patients in each group. There was no statistically significant difference (P>0.05) in postoperative height restoration of fractured vertebrae and correction of the Cobb angle between the two groups. Compared with the manual group, the robot-assisted group exhibited shorter operative duration [(32.5±7.3) vs. (35.4±7.1) minutes], fewer intraoperative fluoroscopic exposure times [(20.6±3.4) vs. (22.9±4.5) times], less puncture deviation, a lower bone cement leakage rate (12.3% vs. 26.2%), and more uniform bone cement distribution within vertebral bodies (P<0.05). ODI and VAS scores were significantly improved at postoperative day 1 and 6 months postoperatively compared with preoperative baseline in both groups (P<0.05), yet no intergroup differences were observed at either time point (P>0.05). Odom’s criteria scores at the final follow-up indicated satisfactory overall clinical outcomes for patients in both groups, with no significant intergroup difference (P>0.05). No additional complications were recorded in either group. Conclusion The application of robot-assisted PKP for thoracolumbar OVCF can shorten the operation time, reduce the radiation exposure dose, optimize the distribution of bone cement within the vertebrae, and decrease the risk of leakage.