So doctor, when would you use one over the other in terms of the kyphoplasty or vertebroplasty? -I would say for the most part that kyphoplasty has replaced vertebroplasty, so as that doctor mentioned when people had compression fractures in the past there were no real good options and what we would do is put them on bed rest or maybe give them a brace, but unfortunately that didn’t work for everybody and so the thing that came along was vertebroplasty and what that is is that procedure that I just described except minus the balloon and so vertebroplasty is inserting the needle into the bone and just injecting cement and this cement will go where it can but oftentimes the compression fracture is so severe but there’s really no good room for the cement to go and so you might get a milliliter or so of cement into the bone. The advantage I think of kyphoplasty is that you can actually get the cement in there because you’ve created a space for it and second you can help to restore height to the bone and so this brings up a very interesting point, people are always worried about them losing height over time from these compression fractures and it’s probably not very noticeable the amount of height that you would lose from a single compression fracture but if you have compression fractures at multiple levels which is often the case then you know if you lose a centimeter here and another centimeter here it actually adds up over time and so you know we all have a grandmother or abuela who you know has lost height over time and everyone everybody wonders why it’s for two reasons they’ve actually lost height of the bone and they’ve also had some curvature of the spine over time and that’s something called kyphosis and so the kyphoplasty helps to prevent that buildup of height loss.