I have a modern one with a screen hanging on the wall. It gets very little play, mostly there for decoration. I would say the biggest difference is that pachinko is a very random game, pinball is more skill.

Pachinko launches a ball up and around the the top, and then you watch it trickle down the pins and hope it falls in the right scoop.

Repeat.

Great for drunk gambling, not a lot of skill involved.