I am female (76 with mild osteoporosis). fell on my back, and have terrible pain. x-rays show t12 compression fracture. orthopaedic surgeon advises 6 weeks bed rest with otc pain meds, while radiologist says emergency kyphoplasty. what is best to do?

Orthopedic surgeon is a doc who specializes in surgery of bones and fractures. I would listen to hem. If you are having severe pain you should discuss with your ORTHO doc or talk to a good internal medicine doc who can consider other pain options including alternative NSAID's / calcitonin / bisphophonates or even short courses of opioids.

Pain without other symptoms of myelopathy is NOT a call for emergency procedure. Spine orthopedist has the final call what to do. In the US, I have never read a formal reading from a radiologist who will indicate what to do with the finding by X-ray. If emergency is truly required, the radiologist will talk to the physician who ordered the test unless you had the X-ray done without the order.