Percutaneous kyphoplasty for stage III Kümmell＇s disease with no neurological symptom

Abstract

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kummell＇s disease with no neurological symptom. Methods From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kummell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. Results All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. Conclusion PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kummell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle. Key words: Vertebroplasty; Kyphosis; Spinal cord compression; Kummell’s disease