Treatment of posterior short-segmental percutaneous pedicle screw fixation combined with unilateral percutaneous vertebroplasty for Kümmell disease stage Ⅲ without neurological symptoms

Abstract

Objective To study the clinical outcome of short segment percutaneous pedicle screw(PPS) combined with unilateral percutaneous vertebroplasty(PVP) for Kümmell disease stage Ⅲ without neurological symptoms. Methods Retrospective analysis of 11 patients with Kümmell disease stage Ⅲ hospitalized in the department of spine surgery of Luoyang Orthopedic-Traumatological Hospital of Henan Province from May 2018 to August 2019(5 males and 6 females),who were received posterior short-segment percutaneous pedicle screw fixation combined with unilateral percutaneous vertebroplasty. The mean age was 72.2 years old, with an average disease course of 5.5 months. All the patients had osteoporosis. The lesion segments included T11, T12 and L1. According to the follow up results,including the operation time,blood loss,the volume of injected bone cement,kyphosis Cobb angle,Oswesay disability index(ODI),height restoration of the vertebral, the incidence of adjacent vertebral fracture and stability of implant were assessed. Results The operations were successfully performed on the 11 patients, and all the patients were followed up for 12 to 15 months, average (14.27±1.01) months. Compared with preoperation, the observational targets (ODI, VAS score, Cobb angle and the height of anterior edge of injured vertebra) in last follow-up and a week after surgery were improved significantly(P＜0.05). Two cases had slight displacement of internal fixation during the follow-up, and 1 case had cement leakage without symptom to the disc during operation. Conclusions Short segment percutaneous pedicle screw fixation combined with unilateral percutaneous vertebroplasty is safe and effective for treatment of Kümmell disease stage Ⅲ without neurological symptoms, alleviate clinical symptoms and reduce the complication of long-term bed rest.

Keywords

• kümmell disease|short-segmental|percutaneous pedicle screw|percutaneous vertebroplasty