Abstract
BackgroundIn recent years, short segment internal fixation combined with vertebroplasty (SSF + VP) has provided a new option for the treatment of Kummell disease (KD). The purpose of this study is to evaluate the efficacy of percutaneous kyphoplasty (PKP) and SSF + VP, to provide evidence-based medical support for the decision-making process when treating KD patients without neurological deficits.MethodsDatabases including MEDLINE (PubMed) and EMBASE (Ovid) (1947 to April 6, 2019) were searched for PKP and short-segmental fixation combined with vertebroplasty (SSF + VP) to treat Kummell disease in randomized controlled trials (RCTs) or cohort studies. Two investigators independently evaluated the eligibility of the studies retrieved from the databases based on the predetermined selection criteria. The postoperative evaluation indexes included operation time, bleeding volume, visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, local vertebral Cobb angle, and cement leakage. When the data were significant, a random-effects model was used for analysis. In contrast, when the results showed no statistical heterogeneity, a fixed-effects model was used to estimate the overall effect sizes.ResultsThree retrospective case-control studies were included in the final analysis. The differences in the bleeding volume and operation time were statistically significant, and the combined weighted mean differences (WMDs) (95% CI) were − 0.204.46 (− 210.97, − 197.93) and − 98.98 (− 141.63, 56.32), respectively.The combined data showed that the differences in VAS score, ODI score, local vertebral Cobb angle, and cement leakage were not statistically significant.ConclusionsThis analysis demonstrates that the PKP and SSF + VP methods are safe and effective in treating Kummell disease patients without neurological symptoms. However, PKP can shorten the operation time and reduce the volume of blood loss.
Highlights
In recent years, short segment internal fixation combined with vertebroplasty (SSF + VP) has provided a new option for the treatment of Kummell disease (KD)
The main diagnostic imaging finding of KD is characterized by an intravertebral vacuum cleft on plain radiograph, which is better appreciated on the anteroposterior view of computed tomography (CT) or magnetic resonance imaging (MRI) scans [3]
Short-segmental fixation combined with vertebroplasty (SSF + VP) has been used to treat KD in recent years
Summary
Short segment internal fixation combined with vertebroplasty (SSF + VP) has provided a new option for the treatment of Kummell disease (KD). Kummell disease (KD) was first reported by Steel in 1951 and occurs in middle-aged and elderly people with osteoporosis. KD presents as a delayed vertebral compression fracture and is characterized by the following common characteristics: a history of minor trauma, after which the pain disappears, but the symptoms recur or worsen, and a kyphosis deformity occurs months or years later [1, 2]. The affected vertebra is usually located in the lower thoracic or upper lumbar region (T8–L4), owing to the well-known prevalence of vertebral fractures at the thoracolumbar junction. There is no standard treatment for KD [1, 4]
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