Aim: Patients with unstable osteoporotic vertebral compression fractures (VCFs) underwent posterior dynamic stabilization (PDS) besides kyphoplasty (KP). The patients were followed up for 12 months. This study aimed to evaluate the role of PDS with KP in the surgical treatment of unstable osteoporotic compression fractures, which are common in the elderly population. KP is a highly preferable surgical method; however, significant decreases in vertebral height may lead to segmental instability. Despite KP treatment, development or progression of kyphosis and persistent chronic back pain are major problems. The PDS technique offers similar stabilization as rigid systems. Materials and Methods: This study included 25 patients with osteoporotic compression fractures. KP with PDS was performed on all patients. Radiological evaluation was performed with magnetic resonance imaging, computed tomography, and plain radiographs. The vertebral kyphosis angle (VKA), local kyphosis angle (LKA), and percentage of collapse were calculated. Clinical evaluation was performed with the visual analog scale and the Oswestry Disability Index (ODI). The preoperative and postoperative clinical and radiological data were compared. Results: The clinical and radiological parameters showed significant improvement following surgical treatment. The mean preoperative visual analog scale score of 7.78 decreased to 0.94 after 12 months. The mean preoperative ODI score of 70.33 decreased to 15.65 after 12 months. The mean preoperative VKA of 17.89° decreased to 9.22° after 12 months. The mean preoperative LKA of 9.61° decreased to 5.50° after 12 months. The mean preoperative percentage of collapse of 32.56% decreased to 19.00% after 12 months. There were no major complications. Conclusions: KP with the PDS method offered satisfactory outcomes in the surgical treatment of unstable osteoporotic compression fractures.