Vertebral compression fractures are most commonly low-energy injuries that occur in patients with underlying osteopenia or osteoporosis. They affect between 700,000 and 1,000,000 persons in the US annually, and 25% of woman in their lifetime.1,2 Many low-energy fractures are treated nonsurgically with a short period of bed rest, pain medications, bracing, and therapy. Approximately 30% to 40% of patients, however, develop disabling pain and/or deformity (kyphosis), resulting in 150,000 hospitalizations annually. Frequently, patients with VCF also have reduced pulmonary function (FVC), increased risk of mortality (compared to age-matched controls), and a lower 5-year survival when compared to hip fracture patients.3 Treatment of symptomatic VCF with vertebral augmentation (vertebroplasty or kyphoplasty) has been shown in various studies to be a cost-effective intervention that both decreases pain and improves survival.4,5,6 Various strategies have been employed to prevent and treat the osteoporosis that predisposes to these “fragility fractures” and is further discussed in the Osteoporosis chapter.