GRADED INFUSION OF BONE CEMENT IN PERCUTANEOUS VERTEBROPLASTY FOR Kummell's DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YAONüzhao , XIAXi , TANGShaofeng

Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang Hunan, 421001, P. R. China;

Corresponding?author：

YAONüzhao, Email: yaonvzhao@sina.com

Keywords：

Kummell's disease; Osteoporosis; Percutaneous vertebroplasty; Bone cement

DOI：

10.7507/1002-1892.20150274

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the safety and effectiveness of graded infusion of bone cement in the unipedicular percutaneous vertebroplasty (PVP) for Kummell's disease. Methods Eighteen patients with Kummell's disease were treated by unipedicular PVP with graded infusion of bone cement between January 2012 and January 2014. Of 18 cases, 6 were male and 12 were female, aged from 65 to 88 years (mean, 75 years), with a disease duration from 3 to 32 months (mean, 11.6 months). The bone mineral density was measured by dual-energy X-ray absorptiometry; the T value ranged from -4.0 to -2.8 (mean, -3.4). Affected segments included T₁₁ in 3 cases, T₁₂ in 10 cases, L₁ in 3 cases, and L₂ in 2 cases. X-ray films were taken after operation to observe bone cement leakage and anterior height changes of affected vertebrae. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess pain status and functional activity. Results All cases underwent smoothly unipedicular PVP and were followed up 12-26 months (mean, 14 months). Cement leakage occurred in 4 patients, including 1 case of anterior paravertebral soft tissue leakage, 2 cases of intervertebral disc leakage, and 1 case of canal venous leakage, but there was no other complications. The anterior height of affected vertebrae were significantly improved (P<0.05) from 29.1%±6.7% at preoperation to 68.1%±7.3% at 3 days after operation and 67.8%±5.9% at last follow-up; the VAS scores were significantly decreased (P<0.05) from 8.11±1.32 at preoperation to 2.14±0.78 at 3 days and 1.97± 0.50 at last follow-up; and ODI were significantly decreased (P<0.05) from 84.6%±8.5% to 24.1%±9.7% and 23.8%±10.2%; but no significant difference was found between at 3 days and at last follow-up (P>0.05). Conclusion Graded infusion of bone cement in unipedicular PVP is a safe and effective procedure for Kummell's disease and this technique could decrease the incidence of bone cement leakage.

Citation： YAONüzhao, XIAXi, TANGShaofeng. GRADED INFUSION OF BONE CEMENT IN PERCUTANEOUS VERTEBROPLASTY FOR Kummell's DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(10): 1265-1268. doi: 10.7507/1002-1892.20150274 Copy

1.	Young WF, Brown D, Kendler A, et al. Delayed post-traumatic osteonecrosis of a vertertebral body (Kummell's disease). Acta Orthop Belg, 2002, 68(1):13-19.
2.	Benedek TG, Nicholas JJ. Delayed traumatic vertebral body compression fracture part Ⅱ:pathologic features. Semin Arthritis Rheum, 1981,10(4):271-277.
3.	Ranjan M, Mahadevan A, Prasad C, et al. Kümmell's diseaseuncommon or underreported disease:A clinicopathological account of a case and review of literature. J Neurosci Rural Pract, 2013, 4(4): 439-442.
4.	Kim YC, Kim YH, Ha KY. Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine. Spine J, 2014, 14(4):659-666.
5.	Yang H, Wang G, Liu J, et al. Balloon kyphoplasty in the treatment of osteoporotic vertebral compression fracture nonunion. Orthopedics, 2010, 33(1):24.
6.	Lee SH, Kim ES, Eoh W. Cement augmented anterior reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell's disease with cord compression. J Clin Neurosci, 2011, 18(4):509-514.
7.	高萬旭, 宓士軍, 高景春. 單側入路經皮椎體成形術治療伴裂隙樣變的骨質疏松性椎體壓縮骨折. 中國修復重建外科雜志, 2012, 26(11):1330-1335.
8.	趙立來, 童培建, 肖魯偉, 等. 球囊擴張椎體后凸成形術治療 Kummell病的療效觀察. 中國骨傷, 2013, 26(5):429-434.
9.	Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889):1127-1131.
10.	Fairbank JC, Couper J, Davies JB, et al. The Oswestry low back pain disability questionnaire. Physiotherapy, 1980, 66(8):271-273.
11.	Ma R, Chow R, Shen FH. Kummell's disease:delayed post traumatic osteonecrosis of the vertebral body. Eur Spine J, 2010, 19(7):1065-1070.
12.	van der Schaaf I, Fransen H. Percutaneous vertebroplasty as treatment for Kummell's disease. JBR-BTR, 2009, 92(2):83-85.
13.	Wu AM, Chi YL, Ni WF. Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis, image, and surgical intervention. Asian Spine J, 2013, 7(2):148-155.
14.	劉繼軍, 劉智勇, 郝陽泉, 等. 椎體后凸成形術治療Kummell病的臨床療效分析. 實用骨科雜志, 2015, 21(7):585-588.
15.	Xing D, Ma JX, Ma XL, et al. A meta-analysis of balloon kyphoplasty compared to percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures. J Clin Neurosci, 2013, 20(6):795-803.
16.	楊惠林, 王根林, 姜為民, 等. 分次灌注骨水泥技術治療Kümmell 病. 脊柱外科雜志, 2012, 10(1):22-24.
17.	Steinmann J, Tingey CT, Cruz G, et al. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine (Phila Pa 1976), 2005, 30(2):201-205.
18.	潘承中, 趙輝, 李立人, 等. 經單、雙側椎弓根入路椎體成形術生物力學比較研究. 交通醫學, 2008, 22(3):224-226.
19.	任海龍, 王吉興, 陳建庭, 等. 單側與雙側穿刺經皮椎體成形術治療Kummell's病的臨床對比. 南方醫科大學學報, 2014, 34(9):1370-1374.

1. Young WF, Brown D, Kendler A, et al. Delayed post-traumatic osteonecrosis of a vertertebral body (Kummell's disease). Acta Orthop Belg, 2002, 68(1):13-19.
2. Benedek TG, Nicholas JJ. Delayed traumatic vertebral body compression fracture part Ⅱ:pathologic features. Semin Arthritis Rheum, 1981,10(4):271-277.
3. Ranjan M, Mahadevan A, Prasad C, et al. Kümmell's diseaseuncommon or underreported disease:A clinicopathological account of a case and review of literature. J Neurosci Rural Pract, 2013, 4(4): 439-442.
4. Kim YC, Kim YH, Ha KY. Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine. Spine J, 2014, 14(4):659-666.
5. Yang H, Wang G, Liu J, et al. Balloon kyphoplasty in the treatment of osteoporotic vertebral compression fracture nonunion. Orthopedics, 2010, 33(1):24.
6. Lee SH, Kim ES, Eoh W. Cement augmented anterior reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell's disease with cord compression. J Clin Neurosci, 2011, 18(4):509-514.
7. 高萬旭, 宓士軍, 高景春. 單側入路經皮椎體成形術治療伴裂隙樣變的骨質疏松性椎體壓縮骨折. 中國修復重建外科雜志, 2012, 26(11):1330-1335.
8. 趙立來, 童培建, 肖魯偉, 等. 球囊擴張椎體后凸成形術治療 Kummell病的療效觀察. 中國骨傷, 2013, 26(5):429-434.
9. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889):1127-1131.
10. Fairbank JC, Couper J, Davies JB, et al. The Oswestry low back pain disability questionnaire. Physiotherapy, 1980, 66(8):271-273.
11. Ma R, Chow R, Shen FH. Kummell's disease:delayed post traumatic osteonecrosis of the vertebral body. Eur Spine J, 2010, 19(7):1065-1070.
12. van der Schaaf I, Fransen H. Percutaneous vertebroplasty as treatment for Kummell's disease. JBR-BTR, 2009, 92(2):83-85.
13. Wu AM, Chi YL, Ni WF. Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis, image, and surgical intervention. Asian Spine J, 2013, 7(2):148-155.
14. 劉繼軍, 劉智勇, 郝陽泉, 等. 椎體后凸成形術治療Kummell病的臨床療效分析. 實用骨科雜志, 2015, 21(7):585-588.
15. Xing D, Ma JX, Ma XL, et al. A meta-analysis of balloon kyphoplasty compared to percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures. J Clin Neurosci, 2013, 20(6):795-803.
16. 楊惠林, 王根林, 姜為民, 等. 分次灌注骨水泥技術治療Kümmell 病. 脊柱外科雜志, 2012, 10(1):22-24.
17. Steinmann J, Tingey CT, Cruz G, et al. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine (Phila Pa 1976), 2005, 30(2):201-205.
18. 潘承中, 趙輝, 李立人, 等. 經單、雙側椎弓根入路椎體成形術生物力學比較研究. 交通醫學, 2008, 22(3):224-226.
19. 任海龍, 王吉興, 陳建庭, 等. 單側與雙側穿刺經皮椎體成形術治療Kummell's病的臨床對比. 南方醫科大學學報, 2014, 34(9):1370-1374.

Chinese Journal of Reparative and Reconstructive Surgery

GRADED INFUSION OF BONE CEMENT IN PERCUTANEOUS VERTEBROPLASTY FOR Kummell's DISEASE

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content