Efficacy of unilateral transverse process‑pedicle and bilateral puncture techniques in percutaneous kyphoplasty for Kummell disease

Abstract

In the present study, the efficacy of unilateral transverse process-pedicle and bilateral puncture techniques in percutaneous kyphoplasty (PKP) for Kummell disease was compared. Between March 2015 and June 2017, 63 patients with Kummell disease were recruited and underwent PKP with two different puncture techniques: A total of 38 patients were treated by unilateral transverse process-pedicle PKP and 25 patients were treated by bilateral PKP. The operative time, intra-operative fluoroscopy time, volume of bone cement injection and bone cement leakage were recorded. Prior to surgery and 1 day post-surgery, the visual analogue scale (VAS) pain score and Oswestry disability index (ODI) were determined, and the vertebral body height and Cobb angle were measured. The results indicated that the incidence of bone cement leakage in the unilateral group was similar with the bilateral group (15.79% vs. 16.00%), with no statistically significant difference between the two groups. None of the patients in the two groups had any obvious damage of the spinal cord. The operative time, intra-operative fluoroscopy time and volume of bone cement injection in the unilateral group were lower than those in the bilateral group. A chest X-ray examination at 1 day post-surgery revealed no pulmonary embolism in the two groups. The VAS score, ODI, vertebral body height and Cobb angle were significantly improved in the unilateral and bilateral groups at 1 day post-surgery and at the last follow-up (12 months post-surgery) as compared with these parameters prior to surgery. In conclusion, the unilateral transverse process-pedicle and bilateral puncture techniques in PKP exhibited good efficacy as a treatment for Kummell disease. The operative time, intra-operative fluoroscopy time and volume of bone cement injection were lower in the unilateral group.

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

“…After filling the fissures in the vertebral body with bone cement, the height and kyphosis deformity of the vertebral body were partially restored and corrected, and the abnormal activity of the injuried vertebral body was eliminated, which was an important reason for pain relief [11]. Previous studies have found that both PVP and PKP can effectively relieve the lower back pain of Kümmell's disease, achieve satisfactory clinical effect, and at the same time partially restore the height of the vertebra and correct the kyphosis [11,[21][22][23][24][25][26][27][28]. During spinal flexion and extension, due to the presence of IVC and the formation of false joints, the injured vertebra of Kümmell's disease can stretch and expand, which can widen the fractured vertebra.…”

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

“…After filling the fissures in the vertebral body with bone cement, the height and kyphosis deformity of the vertebral body were partially restored and corrected, and the abnormal activity of the injuried vertebral body was eliminated, which was an important reason for pain relief [11]. Previous studies have found that both PVP and PKP can effectively relieve the lower back pain of Kümmell's disease, achieve satisfactory clinical effect, and partially restore the height of the vertebra and correct the kyphosis [11,[22][23][24][25][26][27][28][29]. During spinal flexion and extension, due to the presence of IVC and the formation of pseudojoint, the injured vertebra of Kümmell's disease can stretch and expand, which can widen the fractured vertebral body.…”

Comparison of the clinical outcomes and cement distribution patterns after percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease and OVCFs

“…After filling the fissures with bone cement in the fractured vertebrae, the height of the vertebrae was partially restored and kyphosis deformity was partially corrected, and the abnormal activity of the fractured vertebrae was eliminated, which was an important reason for pain relief [2]. Previous studies have found that PVP can effectively relieve low back pain of Kümmell's disease and OVCFs, and partially restore vertebral height and correct kyphosis [2,[23][24][25][26][27][28][29][30]. The ODI and VAS scores in both Kümmell's disease and OVCFs groups decreased after PVP treatment, but the mean score in Kümmell's disease group was higher than that in OVCFs groups [31].…”