MManual reduction combined with percutaneous vertebroplasty for the treatment of Kümmell’s disease
HUANG Wei,ZHANG Wei-xin,CHEN Jia-lin
Department of Orthopaedics, Chuzhou First People's Hospital, Chuzhou 239000, China
Abstract:
Objective To explore the effectiveness and safety of manual reduction combined with percutaneous vertebroplasty (PVP) in treating Kümmell’s disease (KD). Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving manual reduction combined with PVP (30 patients) or percutaneous kyphoplasty (PKP) (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the manual reduction combined with PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. Conclusion Both manual reduction combined with PVP and PKP technologies can significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, manual reduction combined with PVP has the advantages of shorter operation time, less radiation volume and operation cost.
