A comparative study of PSPVP and PSIBG in the treatment of stage II–III Kummell’s disease

Article type: Research Article

Authors: Zhang, Jian-Qiao^a; | Zeng, Zhong-You^b; | Lu, Hui-Gen^{a; c;} | Yu, Wei^b | Hu, Xu-Qi^a | Chen, Wei-Shan^c | Chen, Gang^a;

Affiliations: [a] Department of Spine Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China | [b] Department of Orthopedics, Hospital of Coast Guard General Corps of Armed Police Forces, Jiaxing, China | [c] Department of Spine Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China

Correspondence: [*] Corresponding author: Gang Chen, Department of Spine Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Nanhu District, Jiaxing 314000, China. E-mail: chengangcg19@126.com

Note: [†] These authors contributed equally to this study.

Abstract: BACKGROUND:Percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) are commonly employed for Kummell’s disease in stages II–III; however, these techniques produce some complications. OBJECTIVE:To compare the clinical efficacy and imaging results of percutaneous vertebroplasty + bone cement-augmented short-segment pedicle screw fixation (PSPVP) versus transpedicular intracorporeal bone grafting + pedicle screw fixation (PSIBG) in the treatment of stage II–III Kummell’s disease. METHODS:A total of 69 patients admitted between November 2017 and March 2021 were included in this study; 36 of these were treated with PSPVP, and 33 were treated with PSIBG. Patients in the two groups were compared in terms of perioperative, follow-up, and imaging data. RESULTS:No statistically significant differences were found between the two groups in terms of operation duration (P > 0.05). However, the PSPVP group was superior to the PSIBG group in terms of incision length, intraoperative blood loss, and length of stay (P < 0.05). All patients were followed up for more than 12 months. The VAS score, height of anterior vertebral margin, kyphosis Cobb angle, wedge angle of the affected vertebra at seven days after surgery and last follow-up, and the ODI index at the last follow-up of the two groups were significantly improved compared with figures before surgery (P < 0.05). Compared with values before surgery, no statistically significant differences were found in the height of the posterior vertebral margin in the PSPVP group at seven days after surgery and at the last follow-up (P > 0.05). There were also no statistically significant differences in the VAS score, ODI index, kyphosis Cobb angle, and wedge angle of the affected vertebra between the two groups at corresponding time points (P > 0.05). The heights of the anterior and posterior vertebral margins in the PSIBG group were better than those in the PSPVP group after surgery and at the last follow-up (P < 0.05). In the PSPVP group, a pedicle screw fracture occurred in one patient two months after surgery, while an upper adjacent vertebral fracture occurred in one patient eight months after surgery. CONCLUSION:Both PSPVP and PSIBG can achieve good early clinical efficacy in the treatment of stage II–III Kummell’s disease, with PSPVP being relatively less invasive while producing a poorer orthopedic effect and more complications than PSIBG.

Keywords: Spinal fracture, osteoporosis, kyphosis, Kummell’s disease

DOI: 10.3233/BME-221456

Journal: Bio-Medical Materials and Engineering, vol. 34, no. 3, pp. 261-276, 2023