Kyphoplasty with high viscosity bone cement for the treatment of stage III Kümmell disease without neurological symptoms: restoration of vertebral body height, reduction of kyphoplasty and restoration of column sagittal sequence.

Abstract

BACKGROUND: Percutaneous kyphoplasty is widely used in the treatment of stage I and II Kummell disease, which can rapidly relieve pain, stabilize vertebral body and correct kyphosis;however, the treatment of stage III Kummell disease is still controversial. OBJECTIVE: To evaluate the clinical outcome of kyphoplasty with high-viscosity bone cement for treatment of stage III Kummell disease without neurologic symptoms. METHODS: Twenty-eight patients (11 males and 17 females, aged 57-82 years) with stage III Kummell disease without neurologic symptoms were admitted to Jiangyin People’s Hospital from May 2016 to May 2019, in which T11 vertebral body in 6 cases and T12 vertebral body in 14 cases, L1 vertebral body in 5 cases and L2 vertebral body in 3 cases were treated by kyphoplasty with high viscosity bone cement. At 1 day after operation and 1 year after follow up, postoperative pain and improvement of life ability were evaluated by the Visual Analogue Scale and Oswestry Disability Index. The recovery of vertebral height and correction of kyphosis were measured with X-ray films. The study was approved by the Ethics Committee of Jiangyin People’s Hospital, approval No. [2017](021). RESULTS AND CONCLUSION: (1) Totally 28 patients were followed up for 12-22 months. No serious complications such as wound infection or pulmonary embolism were found during treatment. Asymptomatic cement leakage occurred in three patients. Adjacent vertebral fracture was encountered in 1 patient at 3 months after operation, and healed after kyphoplasty. (2) Visual Analogue Scale, Oswestry Disability Index, and kyphotic angle were lower at 1 day and 1 year after operation than those before operation in 28 patients (P < 0.05). The height of anterior, middle and posterior edges of vertebral body at 1 day and 1 year after operation was higher than that before operation (P < 0.05). (3) The results showed that kyphoplasty with high-viscosity bone cement can relieve back pain, improve viability, retain the vertebral body height, reduce kyphosis, and restore spinal alignment, and is an effective method for treatment of stage III Kummell disease. (English) [ABSTRACT FROM AUTHOR] 背景：经皮球囊扩张椎体后凸成形能够快速缓解疼痛、稳定椎体、矫正脊柱后凸畸形，被广泛用于Ⅰ期、Ⅱ期Kummell病的治疗，但对于 Ⅲ期Kummell病的治疗方法目前尚存在争议。 目的：探讨高黏度骨水泥椎体后凸成形治疗无神经症状Ⅲ期Kummell病的疗效。 方法：选择2016年5月至2019年5月江阴市人民医院收治的无神经症状Ⅲ期Kummell病患者28例，其中男11例，女17例，年龄57-82岁；病 变椎体集中于胸腰段，其中T11椎体6例，T12椎体 14例，L1椎体5例，L2椎体3例，均接受高黏度骨水泥椎体后凸成形治疗。术后1 d及1年随 访时，采用目测类比评分和Oswestry功能障碍指数评价患者术后疼痛和生活能力改善情况，拍摄正、侧位X射线片测量椎体高度恢复和后 凸畸形矫正情况。研究获得江阴市人民医院伦理委员会批准，批件号：[2017]伦审研第(021)号。 结果与结论：①28例患者均顺利完成手术并完成随访，随访12-22个月，治疗过程中未出现伤口感染、肺栓塞等严重并发症，3例发生骨 水泥椎间隙渗漏，未引起临床症状；1例术后3个月出现邻近椎体骨折，行椎体后凸成形治疗后治愈；②28例患者术后1 d、术后1年时的目 测类比评分、Oswestry功能障碍指数评分与局部后凸角均低于术前(P < 0.05)，术后1 d、术后1年时的椎体前缘、中间及后缘高度均高于术 前(P < 0.05)；③结果表明，高黏度骨水泥椎体后凸成形可有效缓解患者腰背痛、改善患者生活能力、恢复椎体高度、减小后凸畸形、恢复 脊柱矢状序列，是治疗无神经症状Ⅲ期Kummell病的有效方法之一. (Chinese) [ABSTRACT FROM AUTHOR] Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo zu zhi gong cheng yan jiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)