Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures is safe and effective and should not be withheld in this group of patients.

Percutaneous vertebroplasty is effective in the treatment of patients with painful vertebral compression fractures with intraosseous vacuum phenomena.

Small to moderate amounts of PMMA may escape from the vertebral body with no significant effect on therapeutic success. Immediate postprocedural pain relief is the best predictor of midterm clinical outcome after vertebroplasty.