Vertebral compression fractures due to osteoporotic disease represent an increasingly significant public health problem [1]. There is no sharp line demarcation between stages of the fracture; acute, subacute and chronic. Lines of treatment include conservative treatment (e.g. brace and pain killers), cement augmentation (vertebroplasty, kyphoplasty and stentoplasty) and surgical treatment. Treatment remains an area of controversy with respect to best line of treatment, and indications, timing and type of surgical management [2]. Percutaneous vertebroplasty began as a simple, low-cost procedure that aimed to provide pain relief for patients with vertebral compression fracture. Balloon kyphoplasty was introduced later, and was presented not only as a “pain killer,” but also as a deformity correction procedure (1). Again, a recently developed technique - stentoplasty includes vertebral body stenting system stabilizes the vertebral body after balloon deflation until cementation [3]. The symptomatic benefits of spinal augmentation for the treatment of osteoporotic vertebral compression fractures are still controversial [4]. Consequently, there is no international agreement about indications of cement augmentation procedures [5]. It is well -understood that the indications differ in different stages of the fracture; acute, subacute and chronic but the indications in every stage at a lot of instants are different in research works. A debate raised by 2 multi- center studies published in the “New England Journal of Medicine” in 2009 comparing vertebroplasty with a sham procedure. The results of these studies showed that improvement in osteoporotic compression fracture pain and pain-related disability was similar in patients treated with vertebroplasty and patients treated with simulated vertebroplasty without cement (sham procedure) [6,7]. However, criticism was directed to these two studies as regards definition of acute fracture, method of enrollment of the patients in the 2 study groups and evaluation of the outcomes. North American Spine Society Statement considered that the conclusions drawn by the authors may not be as decisive as they appear.