Abstract: Although osteoporotic and neoplastic fractures are main indications to vertebroplasty or kyphoplasty, it has been recently suggested that the latter procedure can be a safe and effective treatment also in appropriate patients with traumatic injuries, retaining its advantages in terms of early mobilization. Our results, gathered so far in patients offered the option between kyphoplasty and traditional conservative treatment in real-life clinical settings, are reported here. From June 2005 to September 2007, 24 hospitalized subjects (age:18-76 yrs.; M: 19, F: 5) agreed to undergo kyphoplasty because of a suitable traumatic injury. Specifically, Magerl type A fractures not requiring surgery and involving the spine from T5 through L5 in a non-comatose patient. As cortical bone is usually violated, technique was modified in order to allow for coverage of defects by repeated injections of small amounts of dough-like cement before filling up the bone cavity. Preoperatively, CT scan was performed and standing radiographs obtained to assess vertebral deformity, while clinical data were supplemented by Visual Analog Scale (VAS) pain rating. All of the above were repeated after kyphoplasty. Follow-up evaluations were scheduled at 1, 3, 6, 12 and 24 months. Early mobilization (on the 2nd post-op day) was obtained in all patients, as well as pain relief (baseline VAS score: 7.8 95% CI 7.4-8.2; 48-hr post-op: 1.4 95% CI 0.9-1.9). Radiographic improvement was only slight or moderate. In 6 subjects, limited amounts of cement leakage were spotted. No clinical complications occurred. As it has been already pointed out, conservative therapy of vertebral fractures is neither benign nor risk-free as the term seems to imply. Our data are in keeping with those previously reported that percutaneous vertebral augmentation can produce immediate improvement in a patient’s quality of life. On the other hand, not all of the traumatic spine fractures are suitable for such a procedure but only those with a lower destruction level of the vertebral body. Careful injection technique, in a bone cavity previously remodelled by inflatable bone tamp, can minimize cement leakage and forestall complications.