The treatment evaluation for osteoporotic Kummell disease with kyphosis by posterior spine osteotomy long segment fixation

doi:10.3877/cma.j.issn.2096-0263.2019.01.007

Abstract

Abstract:

Objective

The aim of this study was to evaluate the clinical efficacy of posterior spine osteotomy long segment fixation in treating osteoporotic Kummell disease with kyphosis.

Methods

Between January 2014 to June 2017, 11 patients diagnosed with Kummell disease with kyphosis underwent posterior spine osteotomy long segment fixation treatment, and their medical records were retrospectively collected. There were 3 males and 8 females, average age were (67.2±2.4) years old. Clinical efficacy of Posterior spine osteotomy long segment fixation treatment was evaluated by normal information, kyphotic Cobb's angle, Oswestry disability index (ODI) and visual analogue scale (VAS) score.

Results

11 patients were followed up for more than 1 year. The average follow-up time was 14.6±2.4 months. The average operation time was 240±22 min, the blood loss was 1260±130 ml, the blood transfusion was 600±200 ml, and the X-ray showed Cobb angle was (44±11)° preoperatively, (9±3)° for two weeks after surgery, and (13±4)° at the last follow-up. The results showed that the Cobb's angle after surgery was significantly improved compared with preoperative (F=81.141, P<0.05). In addition, postoperative VAS scores decreased significantly (F=71.962, P<0.05), postoperative ODI was less than preoperative ODI (F=29.031, P<0.05).

Conclusions

Long-segmental fixation of the posterior spinal osteotomy is an effective and safe surgical procedure for the treatment of Kummell's disease with kyphosis, but long-term follow-up studies are still needed.

Key words: Osteoporotic fractures, Kyphosis, Surgical procedures, operative

Wei Li, Yuliang Lou, Renfu Quan. The treatment evaluation for osteoporotic Kummell disease with kyphosis by posterior spine osteotomy long segment fixation[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2019, 05(01): 33-38.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlngkykfdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-0263.2019.01.007

https://zhlngkykfdzzz.cma-cmc.com.cn/EN/Y2019/V05/I01/33

Figures/Tables 2

References 24

1	Kim P, Kim SW. Balloon kyphoplasty:an effective treatment for kummell disease? [J]. Korean J Spine, 2016, 13(3):102-106.
2	Chen GD, Lu Q, Wang GL, et al. Percutaneous kyphoplasty for kummell disease with severe spinal canal stenosis [J]. Pain Physician, 2015, 18(6):E1021-E1028.
3	Zhang X, Hu W, Yu J, et al. An effective treatment option for kümmell's disease with neurological deficits: modified transpedicular subtraction and disc osteotomy combined with Long-Segment fixation [J]. Spine (Phila Pa 1976), 2016, 41(15):E923.
4	Li KC, Wong TU, Kung FC, et al. Staging of kummell’s disease [J]. J Musculoskelet Res, 2008, 08(01):43-55.
5	Zhi-Jun L, Yu-Peng Z, Tian-Wei J, et al. Kyphoplasty with polymethylmethacrylate bone cement treats Kummells disease in the elderly [J]. Chinese Journal of Tissue Engineering Research, 2017.
6	Venmans A, Klazen CA, Lohle PN, et al. Natural history of pain in patients with conservatively treated osteoporotic vertebral compression fractures: results from VERTOS II [J]. AJNR Am J Neuroradiol, 2012, 33(3):519-521.
7	Zhang C, Wang G, Liu X, et al. Failed percutaneous kyphoplasty in treatment of stage 3 Kummells disease: A case report and literature review [J]. Medicine, 2017, 96(47):e8895.
8	Ito Y, Hasegawa Y, Toda K, et al. Pathogenesis and diagnosis of delayed vertebral collapse resulting from osteoporotic spinal fracture [J]. Spine J, 2002, 2(2):101-106.
9	Figura N,Gennafi L,Merlotri D,et al.Prevalence of helicobacter pylof infection in male patients with osteoporosis and controls[J].Dig Dis Sci,2015,50(5):847-852.
10	He D, Yu W, Chen Z, et al. Pathogenesis of the intravertebral vacuum of Kümmell's disease (Review) [J]. Exp Ther Med, 2016, 12(2):879-882.
11	Kim DY, Lee SH, Jang JS, et al. Intravertebral vacuum phenomenon in osteoporotic compression fracture: report of 67 cases with quantitative evaluation of intravertebral instability [J]. J Neurosurg, 2004, 100(1 Suppl Spine):24-31.
12	Ahn SE, Ryu KN, Park JS, et al. Early bone marrow edema pattern of the osteoporotic vertebral compression fracture: can be predictor of vertebral deformity types and prognosis? [J]. J Korean Neurosurg Soc, 2016, 59(2):137-142.
13	Kim H, Jun S, Park SK, et al. Intravertebral vacuum cleft sign: a cause of vertebral cold defect on bone scan [J]. Skeletal Radiol, 2016, 45(5):707-712.
14	Chen L, Dong R, Gu Y, et al. Comparison between Balloon Kyphoplasty and Short Segmental Fixation Combined with Vertebroplasty in the Treatment of Kümmell's Disease [J]. Pain Physician, 2015, 18(4):373-381.
15	Peh WC, Gelbart MS, Gilula LA, et al. Percutaneous vertebroplasty: Treatment of painful vertebral compression fractures with intraosseous vacuum phenomena [J]. AJR Am J Roentgenol, 2003, 180(5):1411-1417.
16	Jung JY, Lee MH, Ahn JM. Leakage of polymethylmethacrylate in percutaneous vertebroplasty:comparison of osteoporotic vertebral compression fractures with and without an intravertebral vacuum cleft [J]. J Comput Assist Tomogr, 2006, 30(3):501-506.
17	Shen M, Wang H, Chen G, et al. Factors affecting kyphotic angle reduction in osteoporotic vertebral compression fractures with kyphoplasty [J]. Orthopedics, 2013, 36(4):e509-e514.
18	Kim JE, Choi SS, Lee MK, et al. Failed percutaneous vertebroplasty due to insufficient correction of intravertebral instability in kummell's disease: a case report [J]. Pain Pract, 2017, 17(8):1109-1114.
19	Huang YS, Hao DJ, Wang XD, et al. Long-segment or Bone Cement-Augmented Short-Segment Fixation for Kummells Disease with Neurological Deficits? A Comparative Cohort Study [J]. World Neurosurg, 2018, 116:1079-1086.
20	Huang J, Feng X, Yang J, et al. Pedicle Screw Fixation Combined with Vertebroplasty to Treat Stage Ⅲ Kummells Disease [J]. Journal of Practical Orthopaedics, Vol.22,No.3,Mar.2016,3:198-224.
21	Kanayama M, Ishida T, Hashimoto TA, et al. Role of major spine surgery using kaneda anterior instrumentation for osteoporotic vertebral collapse [J]. J Spinal Disord Tech, 2010, 23(1):53-56.
22	Xuesong Zhang, Wenhao Hu, Jiayi Yu, et al. An Effective Treatment Option for Ku¨mmell Disease With Neurological Deficits. SPINE Volume 41, Number 15,pp E 923–930.
23	Di HX, Liu FY, Yang SD, et al. Short-segment fixation with a cement-augmented pedicle screw for Kummells disease Case report [J]. Medicine, 2017, 96(50):e8617.
24	Gertzbein SD, Harris MB. Wedge osteotomy for the correction of post-traumatic kyphosis.A new technique and a report of three cases [J]. Spine (Phila Pa 1976), 1992, 17(3):374-379.

项目	术前	术后2 w	末次随访	F值	P值
Cobb角（°）	44±11	9±3^*	13±4^*	81.141	<0.05
VAS评分（分）	6.6±1.2	2.8±1.1^*	1.2±0.9^*	71.962	<0.05
ODI（%）	52±15^*	17±14^*	12±13^*	29.031	<0.05

项目	术前	术后2 w	末次随访	F值	P值
Cobb角（°）	44±11	9±3^*	13±4^*	81.141	<0.05
VAS评分（分）	6.6±1.2	2.8±1.1^*	1.2±0.9^*	71.962	<0.05
ODI（%）	52±15^*	17±14^*	12±13^*	29.031	<0.05

[1]	Jia Su, Jiaying Liu, Kangyan Liu, Fengchun He, Gang Wang, Siwei Xu, Wenzhao Chen, Bo Pei. Efficacy of zoledronate application after percutaneous vertebroplasty [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(05): 562-567.
[2]	Zhan Wang, Yuxin Song, Yaowen Qian. Early oral administration of alendronate in elderly Schatzker type Ⅱ tibial plateau fracture is beneficial to postoperative knee function recovery [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(02): 242-244,247.
[3]	Chengyi Zhao, Qing Li, Daochen Liang, Aiming Zhang, Zhi Mei, Haiyan Yao, Zhidan Fan, Yingchao Chen. Three-year clinical observation for treating aged vertebral compression fractures combined vertebral plasty with anti-osteoporotic drug [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(03): 433-437.
[4]	Guang Xue, Xinming Yang, Ying Zhang. Effect of preemptive analgesia in the treatment of senile osteoporotic vertebral compressed fracture by percutaneous kyphoplasty [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2020, 15(05): 383-388.
[5]	Haibo Sun, Xiaoshan Jing, Hai Tang, Jinjun Li, Li Bao, Shuangjiang Zhang, Hao Chen, Pu Jia, Fei Feng. Effect analysis of different cement volume in percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2019, 14(05): 361-365.
[6]	Bing-xue CHEN, Jie LIU, Bin XU. Sture rectopexy and elevator ani plication for the treatment of complete proctoptosis in adults [J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(04): 308-311.
[7]	Jin Gu. Laparoscopic surgery for rectal cancer：problems and countermeasures [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(01): 9-12.
[8]	Chenxi Gu, Xiao Yu, Anquan Huang, Yefeng Wang, Xiaoqiang Cai, Jun Shen, Tianming Zou. Research progress of different puncture approaches in vertebroplasty for osteoporotic vertebral compression fractures [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(02): 117-122.
[9]	Tongchuan Cai, Feng Wang, Mei Weng, Xinmin Feng, Liang Zhang. Perioperative hidden blood loss in elderly OVCF patients with percutaneous vertebroplasty and influencing factors [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(01): 34-39.
[10]	Zhilin Liang, Chuanyi Zang, Bo Yang, Jie Tang, Xiaolin Zhao, Xunzhe Tong, Maolong Gao. Affecting factors and strategies of surgical treatment for elder people with lumbar disc herniation [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2019, 05(03): 130-134.
[11]	Benqiang Zeng, lingyun Luo, Rui Chang, Yong Yang, Angang Chen, Xiaoqiang Song, Bing Hu, Yi Qin. Investigation on percutaneous kyphoplasty by department's collaboration at primary hospital [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(04): 209-213.
[12]	Xianxuan Feng, Huipeng Shi, Yuehong Bai. Development in rehabilitation of senile osteoporotic fracture [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(01): 48-51.
[13]	Xu Zhang, Chunyang Meng. The factorial analysis and clinic diagnose of responsible centrum adjacent intervertebral disc degeneration after PVP/PKP [J]. Chinese Journal of Diagnostics(Electronic Edition), 2016, 04(03): 213-215.

Please choose a citation manager

Content to export