Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two‑year follow‑up

Xia,Yong‑Hui; Chen,Feng; Zhang,Liang; Li,Gang; Tang,Zhi‑Yu; Feng,Bo; Xu,Ke

doi:10.3892/etm.2018.6628

Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two‑year follow‑up

Authors:
- Yong‑Hui Xia
- Feng Chen
- Liang Zhang
- Gang Li
- Zhi‑Yu Tang
- Bo Feng
- Ke Xu
View Affiliations

Affiliations: Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China, Department of Interventional Radiology, Qianfoshan Hospital, Shandong University, Jinan, Shandong 250014, P.R. China, Department of Interventional Radiology, Jinhua Central Hospital, Jinhua, Zhejiang 321000, P.R. China, Department of Interventional Radiology, Nanchong Central Hospital, Nanchong, Sichuan 637900, P.R. China
Published online on: August 20, 2018 https://doi.org/10.3892/etm.2018.6628
Pages: 3617-3622

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Percutaneous kyphoplasty (PKP) has been used in Kümmell disease treatment for years. The objective of the current study was to evaluate the efficacy and safety of PKP in the treatment of patients with Kümmell disease and to explore the association between cement injection volume and pain relief. A total of 50 patients were enrolled in the present study and follow‑up was 2 years. Efficacy was evaluated using the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI) and the kyphotic angle (Cobb's angle). VAS and ODI were determined at the initial evaluation (prior to surgery), at 3 days, 3 months, and 1 and 2 years post surgery. Cobb's angle was measured prior to and 3 months, 1 year and 2 years following surgery. PKP safety was assessed by evaluating complications, including cement leakage and spinal cord compression. In the follow‑ups, VAS significantly decreased from 7.00±0.78 pre‑PKP to 3.14±0.67 at 2 years post‑PKP (P<0.05). ODI significantly decreased from 73.88±8.60 prior to surgery to 22.84±8.85 at 1 year following surgery (P<0.05) and did not significantly change at the following 2‑year measurement (26.44±8.63). The Cobb's angle, measured at 17.73±2.43˚ preoperatively, significantly decreased to 8.32±2.21˚ at 3 months following surgery (P<0.05). On subsequent follow‑ups at 1 and 2 years, the Cobb's angle increased to 9.55±2.82 and 10.27±3.22˚, respectively. A total of 8 patients exhibited signs of cement leakage during the PKP procedure. No patients experienced severe neurological deficits or complications. Spearman analysis demonstrated a positive correlation between cement injection volume and pain relief. The current study indicated that PKP was a safe and effective treatment for patients with Kümmell disease and that there was a positive correlation between cement injection volume and pain relief. The current study may be used a reference in cement dosing for the treatment of PKP.

View Figures

View References

1	Kim YC, Kim YH and Ha KY: Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine. Spine J. 14:659–666. 2014. View Article : Google Scholar : PubMed/NCBI
2	Wang G, Yang H and Chen K: Osteoporotic vertebral compression fractures with an intravertebral cleft treated by percutaneous balloon kyphoplasty. J Bone Joint Surg Br. 92:1553–1557. 2010. View Article : Google Scholar : PubMed/NCBI
3	Matzaroglou C, Georgiou CS, Panagopoulos A, Assimakopoulos K, Wilke HJ, Habermann B, Panos G and Kafchitsas K: Kümmell's disease: Clarifying the mechanisms and patients' inclusion criteria. Open Orthop J. 8:288–297. 2014. View Article : Google Scholar : PubMed/NCBI
4	Zhang X, Hu W, Yu J, Wang Z and Wang Y: An effective treatment option for kümmell disease with neurological deficits: Modified transpedicular subtraction and disc osteotomy combined with long-segment fixation. Spine (Phila Pa 1976). 41:E923–E930. 2016. View Article : Google Scholar : PubMed/NCBI
5	Ruan J, Gong X, Kong J, Wang H, Zheng X and Chen T: Effect of B vitamin (folate, B6, and B12) supplementation on osteoporotic fracture and bone turnover markers: A meta-analysis. Med Sci Monit. 21:875–881. 2015. View Article : Google Scholar : PubMed/NCBI
6	Chen GD, Lu Q, Wang GL, Zou J, Yang HL, Yang Y and Luo ZP: Percutaneous kyphoplasty for kümmell disease with severe spinal canal stenosis. Pain Physician. 18:E1021–E1028. 2015.PubMed/NCBI
7	Ito Y, Hasegawa Y, Toda K and Nakahara S: Pathogenesis and diagnosis of delayed vertebral collapse resulting from osteoporotic spinal fracture. Spine J. 2:101–106. 2002. View Article : Google Scholar : PubMed/NCBI
8	Zhang GQ, Gao YZ, Zheng J, Luo JP, Tang C, Chen SL, Wang HQ, Liu K and Xie RG: Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kummell's disease with neurological deficits. Exp Ther Med. 5:517–522. 2013. View Article : Google Scholar : PubMed/NCBI
9	Wu AM, Chi YL and Ni WF: Vertebral compression fracture with intravertebral vacuum cleft sign: Pathogenesis, image, and surgical intervention. Asian Spine J. 7:148–155. 2013. View Article : Google Scholar : PubMed/NCBI
10	Chen F, Xia YH, Cao WZ, Shan W, Gao Y, Feng BO and Wang D: Percutaneous kyphoplasty for the treatment of spinal metastases. Oncol Lett. 11:1799–1806. 2016. View Article : Google Scholar : PubMed/NCBI
11	Yu CW, Hsieh MK, Chen LH, Niu CC, Fu TS, Lai PL, Chen WJ, Chen WC and Lu ML: Percutaneous balloon kyphoplasty for the treatment of vertebral compression fractures. BMC Surg. 14:32014. View Article : Google Scholar : PubMed/NCBI
12	Li Y, Gu YF, Sun ZK, Wu CG, Li YD, Wang W, Chen YC and Lu J: Comparison of percutaneous vertebroplasty with and without interventional tumour removal for malignant vertebral compression fractures with symptoms of neurological compression. Eur Radiol. 23:2754–2763. 2013. View Article : Google Scholar : PubMed/NCBI
13	Chin DK, Kim YS, Cho YE and Shin JJ: Efficacy of postural reduction in osteoporotic vertebral compression fractures followed by percutaneous vertebroplasty. Neurosurgery. 58:695–700. 2006. View Article : Google Scholar : PubMed/NCBI
14	Wang GL, Zhu XS and Gan MF: Balloon kyphoplasty for osteoporotic kümmell disease. Bone. 47:s385–s485. 2010. View Article : Google Scholar
15	Zhang J, Fan Y, He X, Meng Y, Huang Y, Jia S, Du J, Wu Q and Hao D: Is percutaneous kyphoplasty the better choice for minimally invasive treatment of neurologically intact osteoporotic Kümmell's disease? A comparison of two minimally invasive procedures. Int Orthop. 42:1321–1326. 2018. View Article : Google Scholar : PubMed/NCBI
16	Zou D, Zhang K and Ren Y: Therapeutic effects of PKP on chronic painful osteoporotic vertebral compression fractures with or without intravertebral cleft. Int J Clin Exp Med. 8:15780–15786. 2015.PubMed/NCBI
17	Cobb J: Outline for the study of scoliosis. AAOS Instr Course Lect. 5:261–275. 1948.
18	Kim DY, Lee SH, Jang JS, Chung SK and Lee HY: Intravertrbral vacuum phenomenon in osteoporotic compression fractures: Report of 67 cases with quantitative evaluation of intravertebral instability. J Neurosurg (1 Suppl Spine). 100:S24–S31. 2004. View Article : Google Scholar
19	Chen L, Dong R, Gu Y and Feng Y: Comparison between balloon kyphoplasty and short segmental fixation combined with vertebroplasty in the treatment of Kummell's disease. Pain Physician. 18:373–381. 2015.PubMed/NCBI
20	Wang G, Yang H, Meng B, Zhu X, Zou J, Gan M, Mei X, Chen K and Tang T: Post-traumatic osteoporotic vertebral osteonecrosis treated using balloon kyphoplasty. J Clin Neurosci. 18:664–668. 2011. View Article : Google Scholar : PubMed/NCBI
21	Barr JD, Barr MS, Lemley TJ and MaCann RM: Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 25:923–928. 2000. View Article : Google Scholar : PubMed/NCBI
22	Xu BS, Tang TS, Hu YC, Ni CF and Yang HL: Vertebroplasty for the treatment of thoracolumbar burst fracture. Chin J Orthop. 22:738–742. 2002.(In Chinese).
23	Matzaroglou C, Georgiou CS, Wilke HJ, Assimakopoulos K, Karageorgos A, Konstantinou D, Velissaris D, Panagiotopoulos E and Kafchitsas K: Kümmell's disease: Is ischemic necrosis or vertebral ‘microcracking’ the first step in the sequence? Med Hypotheses. 80:5052013. View Article : Google Scholar : PubMed/NCBI
24	Oka M, Matsusako M, Kobayashi N, Uemura A and Numaguchi Y: Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: Correlation with cement distribution pattern on Percutaneous vertebroplasty. Acad Radiol. 12:992–999. 2005. View Article : Google Scholar : PubMed/NCBI
25	Baur A, Stäbler A, Arbogast S, Duerr HR, Bartl R and Reiser M: Acute osteoporotic and neoplastic vertebral compression fractures: Fluid sign at MR imaging. Radiology. 225:730–735. 2002. View Article : Google Scholar : PubMed/NCBI
26	Dupuy DE, Palmer WE and Rosenthal DI: Vertebral fluid collection associated with vertebral collapse. AJR Am J Roentgenol. 167:1535–1538. 1996. View Article : Google Scholar : PubMed/NCBI
27	Nakamae T, Fujimoto Y, Yamada K and Matsuura M: The cause of delayed neruologic deficits following osteoporotic vertebral pseudoarthrosis. Spine J. 14:97S2014. View Article : Google Scholar
28	Cho Y: Corpectomy and circumferential fusion for advanced thoracolumbar Kümmell's disease. Musculoskelet Surg. 101:269–274. 2017. View Article : Google Scholar : PubMed/NCBI
29	Zhang GQ, Gao YZ, Chen SL, Ding S, Gao K and Wang HQ: Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of kümmell's disease: A retrospective study. Indian J Orthop. 49:577–582. 2015. View Article : Google Scholar : PubMed/NCBI
30	Yu CW, Hsieh MK, Chen LH, Niu CC, Fu TS, Lai PL, Chen WJ, Chen WC and Lu ML: Percutaneous balloon kyphoplasty for the treatment of vertebral compression fractures. BMC Surg. 14:32014. View Article : Google Scholar : PubMed/NCBI
31	Wang GL, Yang HL and Meng B: Kyphoplasty for osteoporotic kummell's disease. Chin J Spine Spinal Cord. 21:46–49. 2011.