Abstract
BackgroundPercutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD.MethodsThe relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging.ResultsAll patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference.ConclusionPVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.
Highlights
Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologi‐ cally intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous
Kümmell’s disease (KD), known as intravertebral avascular osteonecrosis, is a special type of osteoporotic vertebral compression fracture (OVCF) that most often occurs in the thoracolumbar segment of the spine [1]
percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) have been widely used in patients with neurologically intact osteoporotic KD, especially those who are intolerant to general anesthesia [16,17,18]
Summary
Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologi‐ cally intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Most scholars have basically reached a consensus on the treatment of type III KD [5], but there are still controversies about the choice of surgical methods for type I or II KD ( called neurologically intact osteoporotic KD). Invasive percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) both have good clinical effect in treating neurologically intact osteoporotic KD [6,7,8]. It is still inconclusive which surgical method has more advantages
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