Comparison of Iso-C 3D navigation system versus X-ray fluoroscopy in minimally invasive surgery for Kümmell disease

Abstract

Objective To compare the Iso-C 3D navigation system versus the traditional X-ray fluoroscopy in minimally invasive surgery for Kummell disease. Methods Included for the present retrospective study were 42 patients with Kummell disease who had been treated by percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) at Department of Spine Surgery, Honghui Hospital from October 2016 to June 2018. They were 11 men and 31 women, aged from 43 to 72 years (average, 57.4 years). The operation was aided by Iso-C 3D navigational system in 21 patients (observation group) and by X-ray fluoroscopy in the other 21 patients (control group). The 2 groups were compared before operation, one day and 6 months after operation in terms of visual analogue scale (VAS), Oswestry disability index (ODI), cobb angle and anterior vertebral height. Results The 2 groups were comparable because there were no significant differences between them in the preoperative general data (P>0.05). All the patients were followed up for an average of 9.6 months (from 6.0 to 18.5 months). At one day after operation for the observation and control groups, the VAS scores (2.2±0.7 and 3.9±1.5), ODI scores (15.6±2.8 and 26.2±6.9), cob angles (19.5°±1.7° and 20.8°±0.8°) and anterior vertebral heights (20.7±1.4 and 18.7±1.5 mm) were all significantly improved compared with those before operation (P 0.05). The VAS, ODI, cobb angle and anterior vertebral height at one day after operation for the observation group were all significantly better than those for the control group (P 0.05). No complications were observed in the observation group but 6 cases in control group reported cement leakage. Conclusion In the PKP/PVP treatment of Kummell disease, Iso-C 3D navigational system may be superior to traditional X-ray fluoroscopy in that it can lead to better recovery of anterior vertebral height, kyphosis correction, pain relief and quality of life. Key words: Kummell disease; Osteoporosis; Spinal surgery; Iso-C 3D navigation system