Kümmell's Disease, an Uncommon and Complicated Spinal Disorder: A Review

H, Li; Cz, Liang; Qx, Chen

doi:10.1177/147323001204000202

Cited by 61 publications

(73 citation statements)

References 50 publications

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“…Thus, at these stages, the major aim is to eliminate the mobility of the fractured vertebrae and restore spinal stability (15). By contrast, stage III disease is characterized by rupture of the posterior vertebral wall, together with severe kyphosis and neurospinal symptoms, for which open surgery is recommended (19).…”

Section: Discussionmentioning

confidence: 99%

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

Xiong¹,

Sun²,

Song³

et al. 2019

Exp Ther Med

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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.

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Section: Discussionmentioning

confidence: 99%

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

Xiong¹,

Sun²,

Song³

et al. 2019

Exp Ther Med

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show abstract

“…Thus, it does not fuse well. In consideration to the overall health conditions of these patients and the affordability of expenses, vertebroplasty appears to be a good treatment option compared with open surgery [21,22] and kyphoplasty, due to its minimal invasion and low cost.…”

Section: Discussionmentioning

confidence: 99%

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Guo¹,

Cai²,

Zhang³

et al. 2017

Medicine

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Osteoporotic vertebral compression fractures with intraosseous vacuum phenomena could cause persistent back pains in patients, even after receiving conservative treatment. The aim of this study was to evaluate the efficacy of using high-viscosity bone cement via bilateral percutaneous vertebroplasty in treating patients who have osteoporotic vertebral compression fractures with intraosseous vacuum phenomena.Twenty osteoporotic vertebral compression fracture patients with intraosseous vacuum phenomena, who received at least 2 months of conservative treatment, were further treated by injecting high-viscosity bone cement via bilateral percutaneous vertebroplasty due to failure of conservative treatment. Treatment efficacy was evaluated by determining the anterior vertebral compression rates, visual analog scale (VAS) scores, and Oswestry disability index (ODI) scores at 1 day before the operation, on the first day of postoperation, at 1-month postoperation, and at 1-year postoperation.Three of 20 patients had asymptomatic bone cement leakage when treated via percutaneous vertebroplasty; however, no serious complications related to these treatments were observed during the 1-year follow-up period. A statistically significant improvement on the anterior vertebral compression rates, VAS scores, and ODI scores were achieved after percutaneous vertebroplasty. However, differences in the anterior vertebral compression rate, VAS score, and ODI score in the different time points during the 1-year follow-up period was not statistically significant (P > 0.05).Within the limitations of this study, the injection of high-viscosity bone cement via bilateral percutaneous vertebroplasty for patients who have osteoporotic vertebral compression fractures with intraosseous vacuum phenomena significantly relieved their back pains and improved their daily life activities shortly after the operation, thereby improving their life quality. In this study, the use of high-viscosity bone cement reduced the leakage rate and contributed to their successful treatment, as observed in patients during the 1-year follow-up period.

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“…Fractured vertebrae require several months to achieve adequate mechanical strength and a stable union. Angular kyphosis develops within several weeks or months after injury [33, 34]. Although teriparatide has the potential to increase bone mineral density and vertebral body strength [35, 36], vertebral deformity might progress before the medication has elicited its effects on vertebral mechanical strength.…”

Section: Discussionmentioning

confidence: 99%

Effect of teriparatide (rh-PTH 1–34) versus bisphosphonate on the healing of osteoporotic vertebral compression fracture: A retrospective comparative study

Iwata

Kanayama

Oha

et al. 2017

BMC Musculoskelet Disord

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BackgroundTeriparatide (recombinant human parathyroid hormone 1–34) is increasingly used for the treatment of severe osteoporosis because it stimulates bone formation and may potentially enhance fracture healing. The objective of this study was to investigate the effects of teriparatide versus a bisphosphonate on radiographic outcomes in the treatment of osteoporotic vertebral compression fractures (OVCF).MethodsA total of 98 patients undergoing non-operative treatment for recent single-level OVCF were reviewed retrospectively. Thirty-eight patients were treated by a once-daily subcutaneous injection of 20 micrograms of teriparatide (TPD group), whereas 60 patients received 35 mg of alendronate weekly (BP group). Except for these medications, the same treatment protocol was applied to both groups. The radiographic assessments included union status, vertebral kyphosis, and mid-vertebral body height. The rates of fracture site surgical intervention were also compared between the two groups. The mean follow-up period was 27 months (median 22.5, range 2 – 75 months).ResultsCox regression analysis showed that TPD reduced the time-to-union (adjusted relative hazard ratio: 1.86, 95% C.I.: 1.21 – 2.83). The union rate at six months after treatment was 89% in the TPD group and 68% in the BP group; the surgical intervention rate was significantly higher in the TPD group (p = 0.026, adjusted odds ratio: 8.15, 95% C.I.: 2.02 – 43.33). The change in local kyphosis was 4.6° in the TPD group and 3.8° in the BP group (p = 0.495, paired t-test). The change of mid-vertebral body height was 4.4 mm in the TPD group and 3.4 mm in the BP group (p = 0.228, paired t-test). Fracture site surgical interventions were not required in the TPD group; however, two patients in the BP group eventually underwent surgical treatment for symptomatic non-union or vertebral collapse.ConclusionsThis retrospective study suggests that teriparatide may enhance fracture healing and improve the union rate in OVCF.

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Kümmell's Disease, an Uncommon and Complicated Spinal Disorder: A Review

Cited by 61 publications

References 50 publications

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

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

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Effect of teriparatide (rh-PTH 1–34) versus bisphosphonate on the healing of osteoporotic vertebral compression fracture: A retrospective comparative study

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