Hyperextension reduction combined with bone cement injection by temperature gradient method in percutaneous vertebroplasty for treatment of stage Ⅱ Kümmell disease
Hyperextension reduction combined with bone cement injection by temperature gradient method in percutaneous vertebroplasty for treatment of stage Ⅱ Kümmell disease
Objective To investigate the clinical effects of hyperextension reduction combined with bone cement injection by temperature gradient method in percutaneous vertebroplasty(PVP)for the treatment of stage Ⅱ Kümmell disease.Methods From January 2018 to June 2022,a total of 33 patients with stage Ⅱ Kümmell disease were treated.Among them,21 cases were treated with hyperextension reduction combined with bone cement injection by temperature gradient method in PVP(group A),and 22 were treated with conventional PVP(group B).The operation time,bone cement injection volume,and visual analogue scale(VAS)scores,Oswestry disability index(ODI),anterior height,middle height and Cobb angle of the injured vertebrae at pre-and post-operation were recorded and compared between the 2 groups.The occurrence of postoperative complications,such as bone cement leakage,adjacent vertebral fractures and loosening of bone cement in the 2 groups were recorded.Results All the operations were successfully completed.All the patients were followed up for more than 6 months.The VAS scores,ODI,and anterior height,middle height and Cobb angle of the injured vertebrae in the 2 groups at post-operation improved compared to those at pre-operation,and the improvement of anterior height and Cobb angle of the injured vertebrae in group A were better than those in group B,all with a statistical significance(P＜0.05).The number of patients with postoperative bone cement leakage and loosening in group A was less than that in group B,and the difference was statistically significant(P＜0.05).Conclusions Hyperextension reduction is propitious to recover anterior height of the injured vertebrae and improve local kyphosis,but the anterior edge fissure of the vertebral body increases.Therefore,the temperature gradient method for bone cement injection during PVP is beneficial for sealing the anterior edge fissure of the vertebral body,reducing cement leakage,increasing the riveting effect between bone cement and trabeculae,and reducing the risk of cement loosening and displacement.
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