I have used the stryker kypho kit several times and with the new HV cement and without, and like it for the cost in the ASC. That aside, they have one balloon, 5ml and sell you on the unipedicular approach or if you prefer, place two needles then reinsert balloon and inflate again. The carefusion balloon is the same, but more sizes. So the Kyphon/Medtronic team flew in with their R&D squad to tell me about their new balloon, which is going to come out soon, 4th generation, stronger, can inflate to 700 psi, and is more durable and uniformly inflates as opposed to the old balloons which do not and often would form odd shapes in the vertebra....the new stryker balloons do this as well. Additionally, I think the medtronic biologics have helped them develop new cement with hydroxyapatite for better interdigitation, a new delivery system, and a possible set up for the cement that wont bind to the balloons such that you could fill while keeping one inflated to get the actual "height restoration" which they have been touting. Bottom line...it still costs more, and patients will likely get no better results than with vertebroplasty for pain control. Dupuy has the new confidence kit that has some nice cement for high viscosity, but is pricey and not sure I dig the delivery system. All together, I have used 7 different vert/kypho products this year, which should be an indication that the vert/kypho mkt is getting out of control despite the NEJM article.