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Vertebroplasty (PV) and balloon kyphoplasty (KP) are minimally invasive vertebral augmentation procedures involving injection of polymethyl methacrylate cement under radiologic control into a fractured vertebral body. They strengthen the bone and improve the intense pain caused by fracture secondary to osteoporosis, metastasis, or trauma and refractory to conservative therapies such as analgesic use, bed rest, and bracing. Aim of the study is to investigate and compare safety and efficacy of KP and PV on pain and mobility in patients with vertebral fractures due to osteoporosis or trauma.Twenty-one patients have been enrolled in a prospective nonrandomized controlled study with painful vertebral compression fractures resistant to common therapies. Patients underwent KP or PV. A Visual Analog Scale has been used to measure pain status at different time up to 6 months; the Oswestry Disability Index (ODI) was chosen to evaluate functional activity before procedure and 6 months later.Mean pain scores decreased significantly from pretreatment to posttreatment with KP and PV as did the ODI scores. No significant differences could be found between both groups for the mean VAS and ODI scores preprocedure and postprocedure. Cement extravasation occurred only during PV. No other adverse events correlated to both techniques have been reported.Our results suggest that both PV and KP offer therapeutic benefit significantly reducing pain and improving mobility in patients with vertebral fracture without significant differences between groups in term of quality. The leakage of cement has been observed only during PV.