Kyphoplasty is normally performed under general anesthesia as proper placement of balloon is important before the acrylic cement is injected. The procedure is performed under fluoroscopy or CT scan control. A mono- or bilateral trans- or para-pedicular approach is used to insert a working cannula into the posterior aspect of the vertebral body and two channels are created into the anterior aspect of the vertebral body and the balloon is inserted into the collapsed vertebrae. Once the balloon is entered, it is then inflated under visual and pressure control. The inflation of the balloon results in elevating the depressed endplates of the vertebrae creating a central cavity. Then the balloon is deflated and retracted and the cavity is filled with cement polymethylmethacrylate (PMMA) using a blunt cannula under continuous fluoroscopy