Comparison of Balloon Kyphoplasty, Vertebroplasty and Conservative Management in Acute Osteoporotic Vertebral Fractures

Inclusion Criteria: * Patient is able to undergo the vertebroplasty or Balloon kyphoplasty procedure * Patient must have signed the consent form (ZELEN Randomization protocol) * Male or female, 50 years or older * One or two non-traumatic vertebral fracture(s): * Of osteoporotic origin (low speed trauma such as fall from his own height or less than 80 cm) * Fracture(s) of less than 6 weeks duration after the onset of pain related to the fracture The fracture(s) exhibit(s) high signal intensity on T2-weighted images and a benign appearance at MRI * The patient will be able to receive the selected protocol treatment within 6 weeks after onset of fracture-related symptoms and within 15 days after treatment randomization. * The benign nature of the vertebral fracture has to be confirmed by the results of the biopsy performed during vertebroplasty or balloon kyphoplasty or by one year follow-up in the conservative treatment group. Exclusion Criteria: * Patient with a vertebral fracture of more than 6 week duration after onset of fracture-related symptoms. * Neurological signs related to the vertebral fracture to treat * History of surgical or percutaneous spine treatment except simple discectomy at a single or multiple vertebral levels with no residual pain. * More than two recent vertebral fractures * Current infection * Impossibility to perform the percutaneous approach of the vertebra to treat. * Reduction by more than 50% of the anteroposterior width of the bony spinal canal due to the vertebral fracture to treat. * Known allergy to a contrast media or to one of the cement components used for kyphoplasty. * Vertebral fracture with loss of 90%or more of the vertebral body height * Neurological signs or symptoms related to the vertebral fracture * Malignant and traumatic vertebral fractures * Contraindication to MRI : * Metallic implant : pace-maker, non movable auditive implant, metallic vascular or cardiac device * Metallic surgical clips * Claustrophobia * Evolutive cardiac disease nonreactive to medical treatment * Patient presenting a non correctable spontaneous or therapeutic coagulation disorder. * Presence of an unexplained biological inflammatory syndrome with NFS≥20 * Non compliant patient: Impossibility to participate to the study and to be followed up for 1 year. * Pregnant or breast feeding women * Patient not affiliated to social security