100 patients diagnosed with osteoporotic vertebral compression fractures (VCF) were randomized to receive either vertebroplasty or balloon kyphoplasty. The purpose of the study was to compare the clinical outcomes between these two procedures over a 5 year period. There were no significant differences between groups for vertebral body height, kyphotic wedge angle, visual analog scale (VAS) pain scores, and nonadjacent and adjacent subsequent fractures. A correlation was found between excessive angular correction and the incidence of adjacent fracture in the vertebroplasty group.