Kyphoplasty for the Treatment of Kümmell’s Disease

Abstract

The peripheral cortex of a vertebral body affected by Kümmell's disease is not always intact, resulting in high risk for cement leakage. This study used modified techniques to avoid cement extravasation and dislodgment and investigated the feasibility and efficacy of kyphoplasty for treatment of Kümmell's disease. Between May 2006 and May 2008, 21 consecutive patients with Kümmell's disease underwent kyphoplasty with modified techniques. Each patient was assessed preoperatively with standard examinations and imaged with dynamic radiographs, 3-dimensional computed tomography scans, and magnetic resonance imaging. A visual analog scale (VAS) and the Oswestry Disability Index were used to measure pain and disability pre- and postoperatively and at 6- and 12-month follow-up. One patient had cement leakage into the disk space but no clinical symptoms. There were no cases of cement dislodgment at follow-up. Comparison of the pre- vs postoperative VAS scores revealed significant differences (P<.05), whereas VAS scores at 6- vs 12-month follow-up were similar. The Oswestry Disability Index scores varied from 62.3%+/-15.1% preoperatively to 35.2%+/-12.1% postoperatively (P<.05). This improvement in scores was still present at 6- and 12-month follow-up. At 6- and 12-month follow-up, maintenance of height restoration and kyphotic deformity correction was found. Kyphoplasty may be a relatively safe and effective method for treatment of Kümmell's disease when modified techniques are used to prevent cement leakage and dislodgment.