As the world population ages, vertebral fractures have increased in incidence to a staggering 700,000 in the United States annually (1). Vertebral fractures result in a significant burden on the health care system with approximately 150,000 hospital admissions and 161,000 office visits annually (1). Most fractures are due to osteoporotic bone and are managed nonoperatively with analgesic medications, bracing, bed rest, and/or activity modification. In some patients, however, suffering fractures and their sequelae can mean the difference between independent living and institutionalization. In addition, inactivity in an elderly patient has significant risks with respect to pulmonary toilette, deep vein thrombosis, lost bone density, and decreased muscle mass. Narcotic medications carry their own risks including constipation, sedation, and increased fall risk. Although conservative management typically leads to improvement in pain, residual kyphotic deformity has considerable impact on pulmonary function, self-image, and social functioning (2–5). Initially conceived in the mid-1990s, kyphoplasty is a form of percutaneous vertebral augmentation that uses a balloon tamp and injected bone cement to restore lost vertebral height. Because the inflatable balloon tamp was approved by the FDA in 1998, approximately 200,000 vertebral fractures have been treated in this manner. By providing early pain relief and some restoration of vertebral height, kyphoplasty has become a viable alternative to medical therapy, bracing, and vertebroplasty in the treatment of painful vertebral fractures (Figure 1).