Objective:To evaluate the technique & the early results of patients whounderwent percutaneous polymethylmethacrylate (PMMA) vertebroplasty inthe management of one or more vertebral osteoporotic fractures, vertebralhaemangiomas & painful spinal metastases.Materials and Methods:The technique was used over a 5-year period between April2004 and March 2009 in 63 (42 females and 21 males) patients with 95painful vertebral fractures. The technique involves percutaneous puncture ofthe involved vertebra (e) via a transpedicular approach followed by injectionof polymethylmethacrylate (PMMA) into the vertebral body.The study included 63 patients diagnosed as osteoporotic vertebralcollapse in 51 cases, 8 cases with malignant disease and painful vertebralhaemangioma in 4 cases.The mean age at the time of the procedure was 59.5 years (range 36 –83). Patients complained of axial spinal pain in all cases. In the 95 Vertebroplasties performed, there were one cervical, 15thoracic (T1–10), 58 thoracolumbar (T11–L2), and 21 lumbar (L3–L5)vertebral levels injected. The average amount of cement injected in patientswith osteoporosis and symptomatic hamangioma was 5.5 mL (range 2–9mL). In patients with tumors, a smaller volume (3 mL) of cement wasinjected. The mean number of levels injected was 3 levels (range 1-5).The chief complaint in all patients (100%) was axial spinal pain &local tenderness over spinous process. Patients being considered forvertebroplasty should satisfy the following criteria: severe pain and loss ofmobility that has not be relieved by conventional medical therapy; othercauses of pain has been excluded by appropriate investigations including CTscan or MRI and the affected vertebra should not be significantly destroyed .MRI has a predictive effect in choosing those patients most likely tobenefit from verebroplasty. Patients with osteoporotic vertebral collapseoften have multiple fractures, which are mixture of old and new lesions.Only those lesions showing increased activity on STIR (Short time inversionrecovery) Image should be selected for treatment. The pain and disabilitystatus was prospectively evaluated by a visual analogue scale (VAS) &ADLs. The degree of vertebral filling & cement leakage was evaluated byplane x-ray A-P & lateral views.RESULTS: On a 10-point scale, in osteoporotic patients, the mean visualanalogue scale preoperative was 7.66, decreasing to 1.51. In neoplasticgroup of patients, the mean visual analogue scale preoperative was 8,decreasing to 2.7 after the procedure. In haemangioma cases, the meanvisual analogue scale preoperative was 7, decreasing to 1.5 after theprocedure. Three patients experienced symptomatic complications (none major or lifethreatening).CONCLUSION: Vertebroplasty for the treatment of osteoporoticvertebral collapse, vertebral haemangiomas & painful spinal metastases is aminimally invasive procedure that provides immediate pain relief andenables the patient to become quickly mobile.Vertebroplasty appears to be safe and results in substantial immediatepain reduction and improved functional status (avoiding complications ofprolonged immobilization, the potential adverse effect of strong analgesicssuch as opiates to which elderly people are particularly suspected. AlsoNSAIDS have significant toxicity).Most practitioners would agree that the primary goal of vertebroplastyis to reduce or alleviate the acute symptoms associated with painfulosteoporotic vertebral compression fractures.Many studies have failed to show any positive correlation betweencement volume and pain relief (Sinha et al, 2002).Potential leakage of PMMA during injection is a concern of everyoneperforming vertebroplasty; however, small amounts of leakage recognizedearly that do not pass into the spinal canal or impinge on exiting nerves arewell tolerated.