OBJECTIVE: The aim of this study is to evaluate the feasibility, safety and effectiveness of radiofrequency neurotomy(RFN) for remnant pain after vertebroplasty for the treatment of severe compression fracture. METHODS: 25 patients with remnant pain after vertebroplasty for one level severe compression fracture were treated by RFN. The severe compression fractures were defined to the vertebrae which less than 50% of their original heights have collapsed. Pain relief was evaluated at 2 weeks, 6 weeks and 3 months after the procedure using a visual analog scale(VAS). RESULTS: Successful outcome was determined if pain reduction exceeded 50% on the VAS at 6 weeks. Six of the 25 patients did not respond favorably to RFN (pain reduction less than 50%), and nineteen patients showed successful responses. Mean VAS score was decreased from 5.48 to 2.96 at 6 weeks. CONCLUSION: The radiofrequency neurotomy may be both feasible and useful treatment for the remnant pain after vertebroplasty. However long-term follow up is needed to confirm the effectiveness.