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Introduction: Vertebroplasty (VP) and kyphoplasty (KP) are relatively effective techniques used to treat painful osteoporotic vertebral compression fractures (VCFs).These procedures are most often performed in a percutaneously under the local anasthesia.It is postulated that stabilization of the fracture leads to analgesia.In our serious, used to treat painful osteoporotic compression fractures with good clinical outcomes.One of the major influence clinical outcomes is adjacent vertebral fractures.One of the mechanisms is stress concentration surrounding cement filling level.The risk associated with severe osteoporosis (T-score>-3.0) & fracture side on T-L junction.We used preventive vertebroplasty or kyphoplasty try to avoid adjacent fractures occur.Materials and Methods: Retrospective follow up from Jan.2007 to July 2011, totally 385 patients (535 vertebral bodies) with osteoporotic compression fractures (VCFs) received vertebroplasty (VP) 208 patients and kyphoplasty (KP) 177 patients.Adjacent fractures number on vertebroplasty 12/208(5.8%) and kyphoplasty 10/177(5.6%).In this cases, average the patients T-score is-3.4 (3.0-5.5) and the most fracture side on T-L junction.Prospective follow up from Jan, 2011 to Jan, 2013, totally 76 patients (218 vertebral bodies) with osteoporotic compression fractures (VCFs) received preventive vertebroplasty or kyphoplasty.Most cases used unipedicle approach for cement injection under the local or general anesthesia.Criteria of preventive vertebroplasty or kyphoplasty are T-score:>-3.0 and fracture side on T-L junction, the most preventive cement injected to above and below or between vertebral bodies.Evaluation item include VAS score, serious clinical images average 5 months (3-12months).Results: Totally 76 patients (218 vertebral bodies) received preventive vertebroplasty (VP) or kyphoplasty (KP).VAS score improved average 6 point.Fortunately, no adjacent fractures were occur.Discussion & Conclusion: Vertebroplasty (VP) and kyphoplasty (KP) are safe and effective procedures for management of patients with symptomatic osteoporotic vertebral compression fractures.Then, preventive vertebroplasty and kyphoplasty are effective for avoid adjacent fractures occur.