Abstract
SummaryKümmell’s disease (eponymous name for osteonecrosis and collapse of a vertebral body due to ischemia and non-union of anterior vertebral body wedge fractures after major trauma) cannot heal spontaneously. Bone-filling mesh container (BFMC) can significantly relieve pain, help the correction of kyphosis, and may prevent cement leakage. This pilot study may provide the basis for the design of future studies.PurposeTo compare the effectiveness and safety of BFMC and percutaneous kyphoplasty (PKP) for treatment of Kümmell’s disease.MethodsFrom August 2016 to May 2018, 40 patients with Kümmell’s disease were admitted to Guizhou Provincial People’s Hospital. Among them, 20 patients (20 vertebral bodies) received PKP (PKP group) and the other 20 received BFMC (BFMC group). Operation time, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Cobb’s angle changes, and related complications were recorded.ResultsAll patients underwent operations successfully. VAS scores and ODI of both groups at each postoperative time point were lower than preoperatively, with statistically significant difference (p < 0.05). Postoperative Cobb’s angle of both groups postoperatively was lower than preoperatively (p < 0.05). Cement leakage occurred in eight vertebrae (8/20) in the PKP group and in one vertebra (1/20) in the BFMC group. No complications such as pulmonary embolism, paraplegia, or perioperative death occurred during operation in both groups. Adjacent vertebral refractures occurred in five patients (5/20) in the PKP group and in four patients (4/20) in the BFMC group, with no significant difference in the incidence rate of refractures in both groups but the material is too small to verify statistically.ConclusionsBoth PKP and BFMC technologies can significantly relieve pain and help the correction of kyphosis while treating Kümmell’s disease. Moreover, the BMFC may prevent cement leakage.
Highlights
Osteoporotic vertebral compressive fractures are common lesion in the elderly [1, 2]
Most patients with osteoporotic vertebral compressive fractures can have symptoms progressively relieved after several weeks of non-surgical treatment, but about 1/3 of the patients will have obvious low back pain and kyphosis [3], which may develop into Kümmell’s disease, known as delayed vertebral collapse due to post-traumatic
Patients with Kümmell’s disease are often multi-diseased and are in poor physical condition, and crevasse filling with bone cement may theoretically stabilize the spine and obviously relive pain
Summary
Osteoporotic vertebral compressive fractures are common lesion in the elderly [1, 2]. Most patients with osteoporotic vertebral compressive fractures can have symptoms progressively relieved after several weeks of non-surgical treatment, but about 1/3 of the patients will have obvious low back pain and kyphosis [3], which may develop into Kümmell’s disease, known as delayed vertebral collapse due to post-traumatic. Patients with Kümmell’s disease are often multi-diseased and are in poor physical condition, and crevasse filling with bone cement may theoretically stabilize the spine and obviously relive pain. For such patients, the most commonly used methods at present are percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) [6].
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