***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Summary Bone pain and spinal axial deformity are major concerns in aged patients suffering from osteoporotic vertebral compression fracture ( VCF ) . Pain can be relieved by vertebroplasty or kyphoplasty procedures , in which the compressed vertebral body is filled with substitutes . We r and omly assigned 100 patients with osteoporotic compression fracture at the thoraco-lumbar ( T-L ) junction into two groups : vertebroplasty and kyphoplasty ; we used polymethylmethacrylate ( PMMA ) as the bone filler . Pain before and after treatment was assessed with visual analog scale ( VAS ) scores and vertebral body height and kyphotic wedge angle were measured from reconstructed computed tomography images . More PMMA was used in the kyphoplasty group than in the vertebroplasty group ( 5.56 ± 0.62 vs. 4.91 ± 0.65 mL , p < 0.001 ) . Vertebral body height and kyphotic wedge angle of the T-L spine were also improved ( p < 0.001 ) . VAS pain scores did not differ significantly between the treatment groups . The duration of follow-up was 6 months . Two patients in the kyphoplasty group had an adjacent segment fracture . In terms of clinical outcome there was little difference between the treatment groups . Thus , owing to the higher cost of the kyphotic balloon procedure , we recommend vertebroplasty over kyphoplasty for the treatment of osteoporotic VCFs . Introduction Spinal axial deformities are major concerns in aged patients suffering from osteoporotic vertebral compression fracture . Pain may be relieved by vertebroplasty or kyphoplasty . We investigated the radiological and clinical outcomes of these procedures . Methods One hundred cases of VCF at the thoraco-lumbar junction were r and omly assigned into two groups : vertebroplasty or kyphoplasty ( 50 cases each ) . We used polymethylmethacrylate as the bone filler . Pain before and after treatment was assessed with visual analog scale scores and vertebral body height and kyphotic wedge angle were measured from reconstructed computed tomography images . Results More PMMA was used in the kyphoplasty group than in the vertebroplasty group ( 5.56 ± 0.62 vs. 4.91 ± 0.65 mL , p < 0.001 ) . Vertebral body height and kyphotic wedge angle of the T-L spine were also improved ( p < 0.001 ) . VAS pain scores did not differ significantly between the treatment groups . The duration of follow-up was 6 months . Two patients in the kyphoplasty group had an adjacent segment fracture . Conclusions In terms of clinical outcome there was little difference between the treatment groups . Thus , with the higher cost of the kyphotic balloon procedure , we recommend vertebroplasty over kyphoplasty for the treatment of osteoporotic VCFs In a prospect i ve study , we aim ed to evaluate the potential use of kyphoplasty ( KP ) and vertebroplasty ( VP ) as complementary techniques in the treatment of  painful osteoporotic vertebral compression fractures ( VCFs ) . After 1 month of conservative treatment for VCFs , patients with intractable pain were offered treatment with KP or VP according to a treatment algorithm that considers time from fracture ( Δt ) and amount of vertebral body collapse . Bone biopsy was obtained intra-operatively to exclude patients affected by malignancy or osteomalacia . 164 patients were included according to the above criteria . Mean age was 67.6 years . Mean follow-up was 33 months . 10 patients ( 6.1 % ) were lost to follow-up and 154 reached the minimum 2-year follow-up . 118 ( 69.5 % ) underwent VP and 36 ( 30.5 % ) underwent KP . Complications affected five patients treated with VP , whose one suffered a transient intercostal neuropathy and four a subsequent VCF ( two at adjacent level ) . Results in terms of visual analogue scale and Oswestry scores were not different among treatment groups . In conclusion , at an average follow-up of almost 3 years from surgical treatment of osteoporotic VCFs , VP and KP show similar good clinical outcomes and appear to be complementary techniques with specific different indications UNLABELLED This study investigates the effects of kyphoplasty on pain and mobility in patients with osteoporosis and painful vertebral fractures compared with conventional medical management . INTRODUCTION Pharmacological treatment of patients with primary osteoporosis does not prevent pain and impaired activity of patients with painful vertebral fractures . Therefore , we evaluated the clinical outcome after kyphoplasty in patients with vertebral fractures and associated chronic pain for > 12 months . MATERIAL S AND METHODS Sixty patients with primary osteoporosis and painful vertebral fractures presenting for > 12 months were included in this prospect i ve , nonr and omized controlled study . Twenty-four hours before performing kyphoplasty , the patients self-determined their inclusion into the kyphoplasty or control group so that 40 patients were treated with kyphoplasty , whereas 20 served as controls . This study assessed changes in radiomorphology , pain visual analog scale ( VAS ) score , daily activities ( European Vertebral Osteoporosis Study [ EVOS ] score ) , number of new vertebral fractures , and health care use . Outcomes were assessed before treatment and at 3 and 6 months of follow-up . All patients received st and ard medical treatment ( 1 g calcium , 1000 IE vitamin D(3 ) , st and ard dose of oral aminobisphosphonate , pain medication , physical therapy ) . RESULTS Kyphoplasty increased midline vertebral height of the treated vertebral bodies by 12.1 % , whereas in the control group , vertebral height decreased by 8.2 % ( p = 0.001 ) . Augmentation and internal stabilization by kyphoplasty result ed in a reduction of back pain . VAS pain scores improved in the kyphoplasty group from 26.2 + /- 2 to 44.2 + /- 3.3 ( SD ; p = 0.007 ) and in the control group from 33.6 + /- 4.1 to 35.6 + /- 4.1 ( not significant ) , whereas the EVOS score increased in the kyphoplasty group from 43.8 + /- 2.4 to 54.5 + /- 2.7 ( p = 0.031 ) and in the control group from 39.8 + /- 4.5 to 43.8 + /- 4.6 ( not significant ) . The number of back pain-related doctor visits within the 6-month follow-up period decreased significantly after kyphoplasty compared with controls : mean of 3.3 visits/patient in the kyphoplasty group and a mean of 8.6 visits/patient in the control group ( p = 0.0147 ) . CONCLUSIONS The results of this study show significantly increased vertebral height , reduced pain , and improved mobility in patients after kyphoplasty . Kyphoplasty performed in appropriately selected osteoporotic patients with painful vertebral fractures is a promising addition to current medical treatment BACKGROUND AND PURPOSE : The reported incidence of PCE during PV varies , depending on the sensitivity of diagnostic tests used . To assess the true incidence of PCE , we performed native chest CT during follow-up in a large proportion of patients from the VERTOS II trial . MATERIAL S AND METHODS : VERTOS II is a prospect i ve multicenter r and omized controlled trial comparing PV with conservative therapy  in 202 patients . After a mean follow-up of 22 months ( median , 21 months ; range , 6–42 months ) , 54 of 78 patients ( 69 % ) with 80 vertebrae treated with PV underwent native chest CT to detect possible PCE . The presence , location , number , and size of PCE were recorded . In addition , the presence of pulmonary parenchymal changes adjacent to PCE was noted . Possible risk factors for PCE , such as age , sex , number of treated vertebrae , cement volume per vertebra , and presence and location of perivertebral cement leakage , were evaluated . RESULTS : PCE was detected in 14 of 54 patients ( 26 % 95 % CI , 16%–39 % ) . All patients were asymptomatic . Cement emboli were small and r and omly distributed in peripheral small vessels . There were no reactive pulmonary changes . Cement leakage in the azygos vein was the only risk factor for the occurrence of PCE ( OR , 43 ; 95 % CI , 5–396 ) . CONCLUSIONS : Small and clinical ly silent PCE occurred in a quarter of patients treated with PV . Cement leakage into the azygos vein was the only risk factor . With time , these small cement emboli remained inert , without inflammatory pulmonary response . St and ard postprocedural CT or chest radiographs are not necessary BACKGROUND Vertebroplasty has become a common treatment for painful osteoporotic vertebral fractures , but there is limited evidence to support its use . METHODS We performed a multicenter , r and omized , double-blind , placebo-controlled trial in which participants with one or two painful osteoporotic vertebral fractures that were of less than 12 months ' duration and unhealed , as confirmed by magnetic resonance imaging , were r and omly assigned to undergo vertebroplasty or a sham procedure . Participants were stratified according to treatment center , sex , and duration of symptoms ( < 6 weeks or > or = 6 weeks ) . Outcomes were assessed at 1 week and at 1 , 3 , and 6 months . The primary outcome was overall pain ( on a scale of 0 to 10 , with 10 being the maximum imaginable pain ) at 3 months . RESULTS A total of 78 participants were enrolled , and 71 ( 35 of 38 in the vertebroplasty group and 36 of 40 in the placebo group ) completed the 6-month follow-up ( 91 % ) . Vertebroplasty did not result in a significant advantage in any measured outcome at any time point . There were significant reductions in overall pain in both study groups at each follow-up assessment . At 3 months , the mean ( + /-SD ) reductions in the score for pain in the vertebroplasty and control groups were 2.6+/-2.9 and 1.9+/-3.3 , respectively ( adjusted between-group difference , 0.6 ; 95 % confidence interval , -0.7 to 1.8 ) . Similar improvements were seen in both groups with respect to pain at night and at rest , physical functioning , quality of life , and perceived improvement . Seven incident vertebral fractures ( three in the vertebroplasty group and four in the placebo group ) occurred during the 6-month follow-up period . CONCLUSIONS We found no beneficial effect of vertebroplasty as compared with a sham procedure in patients with painful osteoporotic vertebral fractures , at 1 week or at 1 , 3 , or 6 months after treatment . ( Australian New Zeal and Clinical Trials Registry number , ACTRN012605000079640 . Previously , we reported significantly reduced pain and improved mobility persisting for 6 months after kyphoplasty of chronically painful osteoporotic vertebral fractures in the first prospect i ve controlled trial . Since improvement of spinal biomechanics by restoration of vertebral morphology may affect the incidence of fracture , long-term clinical benefit and thereby cost-effectiveness , here we extend our previous work to assess occurrence of new vertebral fractures and clinical parameters 1 year after kyphoplasty compared with a conservatively treated control group . Sixty patients with osteoporotic vertebral fractures due to primary osteoporosis were included : 40 patients were treated with kyphoplasty , 20 served as controls . All patients received st and ard medical treatment .  Morphological characteristics , new vertebral fractures , pain ( visual analog scale ) , physical function [ European Vertebral Osteoporosis Study ( EVOS ) score ] ( range 0–100 each ) and back-pain-related doctors ’ visits were re-assessed 12 months after kyphoplasty . There were significantly fewer patients with new vertebral fractures of the thoracic and lumbar spine , after 12-months , in the kyphoplasty group than in the control group ( P=0.0084 ) . Pain scores improved from 26.2 to 44.4 in the kyphoplasty group and changed from 33.6 to 34.3 in the control group ( P=0.008 ) . Kyphoplasty treated patients required a mean of 5.3 back-pain-related doctors ’ visits per patient compared with 11.6 in the control group during 12 months follow-up ( P=0.006 ) . Kyphoplasty as an addition to medical treatment and when performed in appropriately selected patients by an interdisciplinary team persistently improves pain and reduces occurrence of new vertebral fractures and healthcare utilization for at least 12 months in individuals with primary osteoporosis BACKGROUND Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful vertebral fractures , which is intended to reduce pain and improve quality of life . We assessed the efficacy and safety of the procedure . METHODS Adults 
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Surgical intervention within the first 7 weeks yielded greater pain reduction than VCFs treated later .
Conclusions BKP/VP  provided greater pain relief and fewer subsequent fractures than NSM in osteoporotic VCFs .
BKP is marginally favored over VP in disability improvement , and significantly favored in QOL improvement  .
BKP had a lower risk of cement extravasation and result ed in greater kyphosis correction .