Osteoporosis is a significant public health problem. Vertebral fractures are the most common fracture in patients with osteoporosis, occurring in approximately 750,000 cases each year. The fractures may cause acute or chronic pain, reduce the quality of life, and shorten life expectancy. Several medications are available that reduce the risk of fracture. Vertebroplasty and kyphoplasty (balloon-inflated expansion of collapsed vertebrae followed by injection of bone cement) may reduce or relieve pain in selected patients. Although surgery is rarely necessary for the management of osteoporotic vertebral fractures, it may be indicated for other reasons. No studies have been conducted to determine if the outcome of spinal fusion is different in patients with osteoporosis and, if it is, whether management of the patient's osteoporosis will improve the outcome.