Patients with pathological or osteoporotic ver-tebral compression fractures may benefit fromvertebral augmentation with polymethylmethac-rylate cement. Vertebroplasty involves injection of the cement through the trocar needle. Kyphoplasty involves inflation of a balloon inserted through a percutaneously placed trocar needle, with subse-quent injection of cement. Anteroposterior and lat-eral fluoroscopic views facilitate optimal placement of the cement. For patients with a sacral insufficiency fracture, cement sacroplasty may help stabilize the fracture. Risks of vertebral augmentation include direct nerve injury (due to placement of the trocar needle), hemorrhage, cement extravasation, and embolic events.