Vertebral augmentation procedures are widely used to treat osteoporotic vertebral compression fractures (VCFs). We report our initial experience with radiofrequency-targeted vertebral augmentation (RF-TVA) in 20 patients aged 50 to 90 years with single-level, symptomatic osteoporotic VCF between T10 and L5, back pain severity >？4 on a 0 to 10 scale, Oswestry Disability Index ≥？21%, 20% to 90% vertebral height loss compared to adjacent vertebral body, and fracture age <？6 months. After treatment, patients were followed through hospital discharge and returned for visits after 1 week, 1 month, and 3 months. Back pain severity improved 66% ( ), from 7.9 (95% CI: 7.1 to 8.6) at pretreatment to 2.7 (95% CI: 1.5 to 4.0) at 3 months. Back function improved 46% ( ), from 74 (95% CI: 69% to 79%) at pretreatment to 40 (95% CI: 33% to 47%) at 3 months. The percentage of patients regularly consuming pain medication was 70% at pretreatment and only 21% at 3 months. No adverse events related to the device or procedure were reported. RF-TVA reduces back pain severity, improves back function, and reduces pain medication requirements with no observed complications in patients with osteoporotic VCF. 1. Introduction Osteoporosis is a devastating disease characterized by low bone density, microarchitectural deterioration of bone tissue, and increased susceptibility to fracture. Vertebral compression fracture (VCF) is a common manifestation of osteoporosis in the elderly with an incidence of 700,000 cases per year in the United States alone [1]. VCFs can precipitate in a downward spiral of physical functioning characterized by chronic back pain, limited mobility, functional impairment, and kyphosis resulting in reduced pulmonary capacity, loss of stature, and greater risk of subsequent nonvertebral and additional vertebral fractures [2, 3]. Vertebral compression fractures also represent a significant economic burden in the United States, accounting for an estimated 17.5 billion dollars in annual medical costs [4]. As the population continues to age, VCFs will remain a serious public health concern. Conservative treatment of painful VCFs, such as bed rest, braces, and/or narcotic analgesic medication, has only modest short-term effectiveness and is associated with poor long-term outcomes, including exacerbation of bone loss, increased risk of subsequent fracture, decreased mobility, and increased mortality [5–7]. Percutaneous techniques such as vertebroplasty and balloon kyphoplasty (BK) are minimally invasive treatments for acutely painful VCFs and have been used with
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