Clinical application of graded sequential percutaneous vertebroplasty in the treatment of Kummell disease
Objective To explore the efficacy and value of graded sequential percutaneous vertebroplasty(PVP)in the treatment of Kummell disease.Methods A series of 32 cases with Kummell disease were surgically treated by graded sequential PVP from June 2018 to June 2022.Of these cases,12 were male and 20 were female,aged from 63 to 92 years old(average:74.5 years)with a disease duration from 3 to 60 months(average:12.3 months).Affected segments included thoracic vertebra in 16 cases and lumbar vertebra in 16 cases.Bilateral puncture was used for 26 cases,while unilateral puncture for 6 cases.X-ray films were carried out after operation to evaluate bone cement filling and leakage.Anterior height and kyphosis angle changes were measured based on preoperative and post-operative radiology results.Visual analogue scale(VAS)and Oswestry disability index(ODI)were recorded to assess clinical effectiveness of surgical treatment.Results All the 32 cases were followed up 12 to 36 months(average:15.3 months).Cement leakage occurred in 7 patients,including 1 case of anterior paravertebral leakage,1 case of intracanal leakage,2 cases of lateral paravertebral leakage,3 cases of intervertebral disc leakage.There was no complication of neurodeficit or pulmonary embolism.The anterior height of the affected vertebrae was significantly improved from(28.6±3.0)%at preoperation to(42.3±6.4)%at 3 days after operation and(42.1±6.4)%at the last follow-up(P<0.05).The kyphosis angle was significantly improved from(18.8±4.7)° at preoperation to(14.2±3.7)° at 3 days after operation and(14.0±3.8)° at the last follow-up(P<0.05).The VAS scores were significantly decreased from(6.91±1.15)at preoperation to(2.34±1.31)at 3 days after operation and(1.22±1.04)at the last follow-up(P<0.05).The ODI was significantly decreased from(82.38±5.93)%to(25.75±8.65)%and(22.75±6.87)%(P<0.05).Significant differences were found in VAS and ODI between at 3 days and at the last follow-up(P<0.05),while no significant difference was found in anterior height of the affected vertebrae and kyphosis angle between the two postoperative time points(P>0.05).Conclusions Graded sequential PVP is a safe and effective procedure for Kummell disease and this technique could decrease the incidence of bone cement leakage and other complications.
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万方数据
维普
