Traditional vertebroplasty (PVP) began in the early 1980s, while balloon-expandable kyphoplasty (PKP) began in the late 1990s, more than a decade later. The latter has been improved based on the lessons learned from the former. On the one hand, the cancellous bone around the cavity left after balloon expansion is compacted, which artificially creates a barrier to prevent bone cement leakage; on the other hand, the use of a pusher to inject bone cement in stages greatly reduces the pressure of bone cement injection compared with the traditional continuous injection by a pressure pump, so that the leakage of bone cement is greatly reduced. It has been reported that the cement leakage rate in spherical PKP is about 10%, while the cement leakage in conventional vertebroplasty can be as high as 80% or more. Of course, there may be differences in operator technique here, but this is still the greatest advantage of PKP over conventional PVP. Second, PVP is superior to conventional PVP in restoring vertebral height and correcting kyphosis, and the results of ex vivo experiments comparing the two in restoring vertebral height showed that 97% of the lost height was restored with the balloon, while only 30% was restored with conventional PVP. Reducing the leakage rate equates to a reduction in surgical complications, while restoring vertebral height, improving kyphosis, and maintaining normal spinal sequences in turn has a beneficial effect on preventing the development of future back pain in patients. Thus PKP is clearly superior to conventional PVP, but the medical expenses are considerably higher due to the use of the balloon.