Osteoporotic wedge fractures (Fig. 2.25) typically occur in the thoracolumbar region, and the approach to performing vertebroplasty is novel and relatively straightforward. The procedure is performed under sedation or light general anesthetic. Using X-ray guidance the pedicle is identified on the anteroposterior image. A metal cannula is placed through the pedicle into the vertebral body. Liquid bone cement is injected via the cannula into the vertebral body (Fig. 2.26). The function of the bone cement is two-fold. First, it increases the strength of the vertebral body and prevents further loss of height. Furthermore, as the bone cement sets, there is a degree of heat generated that is believed to disrupt pain nerve endings. Kyphoplasty is a similar technique that aims to restore some or all of the lost vertebral body height from the wedge fracture by injecting liquid bone cement into the vertebral body.