The patient is positioned horizontally (prone) on the operating table.  Percutaneous vertebroplasty can be performed under sedation and local anesthesia. Fluoroscopy, a special type of x-ray used during some spine procedures, is implemented to identify the vertebral pedicles and is used for needle guidance. A special bone needle is inserted through the skin (percutaneous) and positioned. The cement is mixed to the consistency of thin paste and prepared for syringe injection through the needle.  Fluoroscopy allows the doctor to watch and guide the needle and cement mixture during the injection process. After vertebral filling, the syringe and needle is withdrawn. As the cement cures (hardens) the vertebral body is stabilized.