A Comparison of Hyperextension versus Neutral Positions for Vertebroplasty to Treat Neurologically Intact Kümmell Disease.

Abstract

To compare the efficacy between hyperextension position (HPVP) and neutral position for vertebroplasty (NPVP) in treating Kümmell disease. A Comparative descriptive study. Department of Orthopaedics, Yantaishan Hospital, China, from December 2017 to July 2018. This study retrospectively analysed demographic features, operative information, radiologic data, and complications of 58 consecutive patients with single-level Kummel disease (KD) who underwent NPVP (n=27) or HPVP (n=31). All patients were observed preoperatively and at 2 days (POD 2) and one year postoperatively for cement leakage, Cobb's angle, antenior body height ratio, pain and disability. The cement leakage rate was significantly lower in the HPVP group (p<0.01). The visual analogue scale (VAS) scores for pain, and Oswestry disability indices (ODIs) were lower in the HPVP group at one year postoperatively (both p<0.05). For the HPVP group, Cobb's angle was significantly smaller, and the anterior body height ratio (AR) was larger at POD 2 (p<0.05) and one year (p<0.05), postoperatively. This study demonstrated that HPVP could achieve a lower cement leakage rate with similar operative time, lower VAS and ODI scores, as well as better kyphosis restoration and AR recovery at the 1-year follow-up than NPVP. HPVP is thus superior to NPVP in treating KD. Key Words: Kyphosis, Cobb's angle, Cement leakage, Intervertebral stability, Surgical outcome, Kümmell disease, Vertebroplasty, Hyperextension position.