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Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease

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机构: [1]Kunming Univ Sci & Technol, Fac Med Sci, Kunming, Peoples R China [2]Kunming Univ Sci & Technol, Affiliated Hosp, Peoples Hosp 1, Dept Orthopaed, 157 Jinbi Rd, Kunming 650032, Peoples R China [3]Kunming Univ Sci & Technol, Affiliated Hosp, Yunnan Key Lab Digital Orthopaed, Kunming, Peoples R China
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关键词: K & uuml mmell disease hollow pedicle screw bone cement displacement finite element analysis biomechanical

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Background Vertebral augmentation is the preferred treatment for K & uuml;mmell disease (KD), but there exists a risk of cement displacement resulting in severe back pain and exacerbation of kyphosis. The study aimed to investigate the efficacy and safety of a novel hollow pedicle screw combined with kyphoplasty (HPS-KP) for treating KD, effectively preventing postoperative bone cement displacement. Methods The prospective study included 50 KD patients with no neurological deficit detected during clinical and radiological evaluation who underwent HPS-KP (n = 25) and PKP (n = 25) surgeries. The visual analogue scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), wedge-shape affected vertebral Cobb angle (WCA), bisegmental Cobb angle (BCA), and complications were evaluated and compared in both groups. Besides, a finite element (FE) model of T11-L2 was constructed. The stress distributions, maximum von Mises stresses of vertebrae and bone cement, and maximum displacement of bone cement were compared and analyzed. Results The VAS and ODI scores at 3 days, 3 and 6 months, and 1 year after surgery significantly improved in both groups (p < 0.05). The AVH, BCA, and WCA significantly improved initially after the surgery in both groups (p < 0.05). The displacement of M2 was larger than other models, especially in flexion, right bending, and left and right rotation, while that of M6 was the lowest under all conditions. Conclusion HPS-KP was a safe and effective treatment for KD, effectively relieving pain, restoring vertebral height, and correcting local kyphosis, and it had better biomechanical stability and safety than ordinary single PKP and PKP combined with pediculoplasty in avoiding cement loosening and displacement.

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大类 | 3 区 医学
小类 | 3 区 骨科
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Q1 ORTHOPEDICS
最新[2023]版:
Q1 ORTHOPEDICS

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]Kunming Univ Sci & Technol, Fac Med Sci, Kunming, Peoples R China [2]Kunming Univ Sci & Technol, Affiliated Hosp, Peoples Hosp 1, Dept Orthopaed, 157 Jinbi Rd, Kunming 650032, Peoples R China
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通讯机构: [1]Kunming Univ Sci & Technol, Fac Med Sci, Kunming, Peoples R China [2]Kunming Univ Sci & Technol, Affiliated Hosp, Peoples Hosp 1, Dept Orthopaed, 157 Jinbi Rd, Kunming 650032, Peoples R China [3]Kunming Univ Sci & Technol, Affiliated Hosp, Yunnan Key Lab Digital Orthopaed, Kunming, Peoples R China
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