Prevention of Bone Cement Displacement in Kummell Disease without Neurological Deficits through Treatment with a Novel Hollow Pedicle Screw Combined with Kyphoplasty
ObjectiveDisplacement of bone cement following percutaneous vertebral augmentation for Kummell disease (KD) presents a significant concern, resulting in increasing back pain and compromising daily activities. Unfortunately, current literature does not yet establish a validated and minimally invasive surgical intervention for this issue. This study aims to investigate the effects of a novel hollow pedicle screw combined with kyphoplasty (HPS-KP) in preventing bone cement displacement following simply percutaneous kyphoplasty for the management of KD. MethodsA total of 22 patients (six males, 16 females, averagely aged 77.18 & PLUSMN; 7.63 years) with KD without neurological deficits treated by HPS-KP at the hospital between March 2021 and June 2022 were hereby selected, among which, there were three stage I KD cases, 12 stage II KD cases, and seven stage III KD cases according to Li's classification. Bone mineral density (BMD), spinal X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) were examined before the operation. The operation time, intraoperative blood loss, and postoperative complications were all recorded. The follow-up focused on visual analog scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), wedge-shape affected vertebral Cobb angle (WCA), and bisegmental Cobb angle (BCA). One-way analysis of variance (ANOVA) followed by Bonferroni post-hoc test was employed for performing multiple comparisons in the present study. ResultsAll patients having received the operation successfully were followed up for more than 8 months (ranging from 8 to 18 months). The operation time, intraoperative blood loss, and BMD (T-score) were 39.09 & PLUSMN; 5.64 min, 14.09 & PLUSMN; 3.98 ml, and - 3.30 & PLUSMN; 0.90 g/cm(3), respectively. Statistically significant differences were observed in the VAS score, ODI, AVH, MVH, and WCA (All p < 0.05), but there was no statistically significant difference in PVH and BCA at different time points (All p > 0.05). During follow-up, five patients suffered from bone cement leakage, and one presented an adjacent vertebral fracture and no bone cement displacement. ConclusionHPS-KP could be safe and effective in the treatment of KD without neurological deficits, effectively relieving the symptoms of patients, restoring partial vertebral height, and preventing the occurrence of bone cement displacement.
基金:
National Natural Science Foundation of China [82260257]; Key Research Project of Yunnan Provincial Science and Technology [202102AA310042]; Yunnan Health Training Project of High-Level Talents [H-2018100]; Key Project of Yunnan Clinical Medicine Research Center [2022YJZX-GK02]; Training and Development Project of Yunnan Clinical Medicine Center [2021LCZXXF-CS02]
第一作者机构:[1]Kunming Univ Sci & Technol, Fac Med Sci, Kunming, Peoples R China[2]Kunming Univ Sci & Technol, Peoples Hosp Yunnan Prov 1, Dept Orthopaed, Affiliated Hosp, Kunming, Peoples R China
通讯作者:
通讯机构:[1]Kunming Univ Sci & Technol, Fac Med Sci, Kunming, Peoples R China[2]Kunming Univ Sci & Technol, Peoples Hosp Yunnan Prov 1, Dept Orthopaed, Affiliated Hosp, Kunming, Peoples R China[3]Yunnan Key Lab Digital Orthopaed, Kunming, Peoples R China
推荐引用方式(GB/T 7714):
Zhong Shixiao,Bao Feilong,Fan Qianbo,et al.Prevention of Bone Cement Displacement in Kummell Disease without Neurological Deficits through Treatment with a Novel Hollow Pedicle Screw Combined with Kyphoplasty[J].ORTHOPAEDIC SURGERY.2023,15(10):2515-2522.doi:10.1111/os.13815.
APA:
Zhong, Shixiao,Bao, Feilong,Fan, Qianbo,Zhao, Yayu&Li, Weichao.(2023).Prevention of Bone Cement Displacement in Kummell Disease without Neurological Deficits through Treatment with a Novel Hollow Pedicle Screw Combined with Kyphoplasty.ORTHOPAEDIC SURGERY,15,(10)
MLA:
Zhong, Shixiao,et al."Prevention of Bone Cement Displacement in Kummell Disease without Neurological Deficits through Treatment with a Novel Hollow Pedicle Screw Combined with Kyphoplasty".ORTHOPAEDIC SURGERY 15..10(2023):2515-2522