***TASK*** the task is to summarize 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 Study Design . An Institutional Review Board-approved Phase I efficacy study of inflatable bone tamp usage in the treatment of symptomatic osteoporotic compression fractures . Objectives . To evaluate the safety and efficacy of inflatable bone tamp reduction and cement augmentation , “ kyphoplasty , ” in the treatment of painful osteoporotic vertebral compression fractures . Summary of Background Data . Osteoporotic compression fractures can result in progressive kyphosis and chronic pain . Traditional treatment for these patients includes bed rest , analgesics , and bracing . Augmentation of vertebral compression fractures with polymethylmethacrylate , “ vertebroplasty , ” has been used to treat pain . This technique , however , makes no attempt to restore the height of the collapsed vertebral body . Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps into the vertebral body . Once inflated , the bone tamps restore the vertebral body back toward its original height while creating a cavity that can be filled with bone cement . Patients and Methods . Seventy consecutive kyphoplasty procedures were performed in 30 patients . The indications included painful primary or secondary osteoporotic vertebral compression fractures . Mean duration of symptoms was 5.9 months . Symptomatic levels were identified by correlating the clinical data with MRI findings . Perioperative variables and bone tamp complications or issues were recorded and analyzed . Preoperative and postoperative radiographs were compared to calculate the percentage height restored . Outcome data were obtained by comparing preoperative and latest postoperative SF-36 data . Results . At the completion of the Phase I study there were no major complications related directly to use of this technique or use of the inflatable bone tamp . In 70 % of the vertebral bodies  kyphoplasty  restored 47 % of the lost height . Cement leakage occurred at six levels ( 8.6 % ) . SF-36 scores for Bodily Pain 11.6–58.7 , ( P = 0.0001 ) and Physical Function 11.7–47.4 , ( P = 0.002 ) were among those that showed significant improvement . Conclusions . The inflatable bone tamp was efficacious in the treatment of osteoporotic vertebral compression fractures .  Kyphoplasty is associated with early clinical improvement of pain and function as well as restoration of vertebral body height in the treatment of painful osteoporotic compression fractures BACKGROUND Percutaneous vertebroplasty is increasingly used for treatment of pain in patients with osteoporotic vertebral compression fractures , but the efficacy , cost-effectiveness , and safety of the procedure remain uncertain . We aim ed to clarify whether vertebroplasty has additional value compared with optimum pain treatment in patients with acute vertebral fractures . METHODS Patients were recruited to this open-label prospect i ve r and omised trial from the radiology departments of six hospitals in the Netherl and s and Belgium . Patients were aged 50 years or older , had vertebral compression fractures on spine radiograph ( minimum 15 % height loss ; level of fracture at Th5 or lower ; bone oedema on MRI ) , with back pain for 6 weeks or less , and a visual analogue scale ( VAS ) score of 5 or more . Patients were r and omly allocated to percutaneous vertebroplasty or conservative treatment by computer-generated r and omisation codes with a block size of six . Masking was not possible for participants , physicians , and outcome assessors . The primary outcome was pain relief at 1 month and 1 year as measured by VAS score . Analysis was by intention to treat . This study is registered at Clinical Trials.gov , number NCT00232466 . FINDINGS Between Oct 1 , 2005 , and June 30 , 2008 , we identified 431 patients who were eligible for r and omisation . 229 ( 53 % ) patients had spontaneous pain relief during assessment , and 202 patients with persistent pain were r and omly allocated to treatment ( 101 vertebroplasty , 101 conservative treatment ) . Vertebroplasty result ed in greater pain relief than did conservative treatment ; difference in mean VAS score between baseline and 1 month was -5·2 ( 95 % CI -5·88 to -4·72 ) after vertebroplasty and -2·7 ( -3·22 to -1·98 ) after conservative treatment , and between baseline and 1 year was -5·7 ( -6·22 to -4·98 ) after vertebroplasty and -3·7 ( -4·35 to -3·05 ) after conservative treatment . The difference between groups in reduction of mean VAS score from baseline was 2·6 ( 95 % CI 1·74 - 3·37 , p<0·0001 ) at 1 month and 2·0 ( 1·13 - 2·80 , p<0·0001 ) at 1 year . No serious complications or adverse events were reported . INTERPRETATION In a subgroup of patients with acute osteoporotic vertebral compression fractures and persistent pain , percutaneous vertebroplasty  is effective and safe . Pain relief after vertebroplasty is immediate , is sustained for at least a year , and is significantly greater than that achieved with conservative treatment , at an acceptable cost . FUNDING ZonMw ; COOK Medical Introduction As life expectancy in the population rises , osteoporotic fractures are seen most frequently in the proximal femur and the vertebral column . In balloon kyphoplasty and vertebroplasty , we have two minimally invasive treatment procedures available . Although they have both been controversially discussed in studies , they have seldom been directly compared . Material s and methods Between 2002 and 2004 , patients with fresh thoracic or lumbar single-segment vertebral compression fractures not involving neurological deficits were treated by balloon kyphoplasty  ( n = 30 ) or vertebroplasty(n = 30 ) using PMMA cement , and the results of the two interventions were compared in a prospect i ve , nonr and omised cohort study . Surgery was indicated when patients had painful , dislocated fractures of type A1 and type A3 according to Magerl ’s classification . The outcome of treatment was assessed with special reference to the angle of kyphosis , back pain ( VAS ) , health-related quality of life ( SF-36 ) and complications . Results At the time of the follow-up examination , significant improvement in the angle of kyphosis was found to have been achieved both by kyphoplasty and by vertebroplasty ( P < 0.001 and P = 0.002 , respectively ) . Comparison showed that correction of the angle was significantly ( P < 0.001 ) better in the kyphoplasty group . Both surgical procedures led to significant ( P < 0.001 ) attenuation of the patients ’ pain ; no difference was observed between the groups in the degree of pain relief achieved . There was no demonstrable correlation in either group between the preoperative pain experienced by the patients and the degree of dislocation of their fractures . In both study groups , the quality of life was in keeping with that of a reference group matched for age and sex . Cement leakage was observed in 7 % of patients after kyphoplasty and in 33 % of patients after vertebroplasty ( P = 0.021 ) . Adjacent-level fractures were checked for , but occurred in only one patient in the vertebroplasty group . Conclusion The two surgical procedures were both followed by significant pain relief , and the quality of life was similar regardless of the procedure used . Balloon kyphoplasty led to an ongoing reduction of freshly fractured vertebrae and was followed by a lower rate of cement leakage CONTEXT Risedronate , a potent bisphosphonate , has been shown to be effective in the treatment of Paget disease of bone and other metabolic bone diseases but , to our knowledge , it has not been evaluated in the treatment of established postmenopausal osteoporosis . OBJECTIVE To test the efficacy and safety of daily treatment with risedronate to reduce the risk of vertebral and other fractures in postmenopausal women with established osteoporosis . DESIGN , SETTING , AND PARTICIPANTS R and omized , double-blind , placebo-controlled trial of 2458 ambulatory postmenopausal women younger than 85 years with at least 1 vertebral fracture at baseline who were enrolled at 1 of 110 centers in North America conducted between December 1993 and January 1998 . INTERVENTIONS Subjects were r and omly assigned to receive oral treatment for 3 years with risedronate ( 2.5 or 5 mg/d ) or placebo . All subjects received calcium , 1000 mg/d . Vitamin D ( cholecalciferol , up to 500 IU/d ) was provided if baseline levels of 25-hydroxyvitamin D were low . MAIN OUTCOME MEASURES Incidence of new vertebral fractures as detected by quantitative and semiquantitative assessment s of radiographs ; incidence of radiographically confirmed nonvertebral fractures and change from baseline in bone mineral density as determined by dual x-ray absorptiometry . RESULTS The 2.5 mg/d of risedronate arm was discontinued 
    Output:
    
The outcome showed that VP is more effective in the short-term ( no more than seven days ) pain relief .
Kyphoplasty had a superior capability for intermediate-term ( around three months ) functional improvement .
As for long-term pain relief and functional improvement , there is no significant difference between these two interventions .
Consistently , both interventions have similar risk for subsequent fracture and cement leakage .
Conclusion Thus considering the higher cost of the KP procedure , we recommend VP over KP for the treatment of osteoporotic VCFs