Here we have addressed the queries raised.

1. We performed vertebral percutaneous biopsies for all vertebral compression fractures except for those that met our exclusion criteria.

2. In the Indian population, the cost of any procedure matters more than its advantages. Many patients refused vertebroplasty, kyphoplasty, or stabilization.

3. No patients in our series with known malignancies had a benign vertebral lesion based on the histopathological diagnosis.

4. Patients who had a homogenous decrease in the signal on T1-weighted images and increased signal intensity on T2-weighted images with fat suppression in multiple vertebrae showed the presence of multiple myeloma on histopathological diagnosis. We did not find any conclusive association of our findings with other conditions.

5. Out of 69 patients with osteoporotic vertebral compression fractures (VCFs), 10 had mild lymphocyte infiltration.

6. We performed vertebral percutaneous biopsies for all patients with vertebral compression fractures except for those who met our exclusion criteria. We also excluded young patients with a significant history of trauma. Patient selection becomes important when trying to avoid inconclusive result. If someone is planning to perform kyphoplasty or vertebroplasty in a VCF patient without any evidence of malignancy, a biopsy should be conducted.