The Use of Three-Column Enhanced Percutaneous Vertebroplasty to Treat Kummell's Disease

J Pain Res. 2022 Sep 15:15:2919-2926. doi: 10.2147/JPR.S370578. eCollection 2022.

Abstract

Purpose: To describe the operative technique and clinical effects of three-column enhanced percutaneous vertebroplasty used to treat Kummell's disease.

Methods: From April 2017 to April 2020, 39 patients with Kummell's disease were treated via three-column enhanced percutaneous vertebroplasty. There were 12 males and 27 females of average age 70.23 ± 7.41 years. The operative time, volume of bone cement injected, and intraoperative cement leakage were recorded. The patients were re-examined postoperatively. The VAS was used to evaluate low back pain and the ODI score to evaluate improvement in the quality-of-life.

Results: All patients were successfully operated upon; the average operation time was 35.1±4.7 min and average volume of bone cement injected 4.5±0.92 mL. Five cases exhibited bone cement leakage during operation, two into the intervertebral disc and three into the anterior upper margin of the vertebral body. No leakage into the vertebral canal occurred. The average hospital stay was 2.50±0.86 days. The VAS score before operation was 7.47±0.24, but low back pain symptoms were significantly relieved after operation (P < 0.05). The VAS scores at 1 day and 1, 3, 6, and 12 months after operation were 2.91±0.09, 2.04±0.07, 1.59±0.05, 1.28±0.15, and 0.8±0.18, respectively. The preoperative ODI score was 72.97±1.45 and significantly decreased postoperatively (P < 0.05), being 30.08±1.79 at 1 day, and 25.35±0.94, 23.19±1.76, 20.49±0.65, and 20.05±0.58 at 1, 3, 6, and 12 months after operation respectively.

Conclusion: Three-column enhanced percutaneous vertebroplasty effectively treats Kummell's disease. The surgical trauma is low, recovery rapid, and bone cement fixation firm, especially in patients with stage I and II disease.

Keywords: Kummell’s disease; surgical technique; three-column enhancement; vertebroplasty.

Grants and funding

This work was supported by Key Scientific Research Projects of Universities in Henan Province (21B320004), Joint Co-construction Project of Henan Medical Science and Technology Research Plan (LHGJ20200887), Luohe Youth Talents Fund of China (2018QNBJRC01004), and Luohe Medical College Innovation and Entrepreneurship Promotion Project (2019-LYZKYZD004 & 2019-LYZKYYB016).