Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SUN Yuliang ,  XIONG Xiaoming , WAN Dun , DENG Xuangeng , SHI Huagang , SONG Simao , GU Tao , HOU Wei , ZHOU Jie

Department of Spine Surgery, Sichuan Provincial Orthopedics Hospital, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

XIONG Xiaoming, Email: 2841710476@qq.com

Keywords：

Vesselplasty; percutaneous kyphoplasty; Kümmell disease; bone cement leakage

DOI：

10.7507/1002-1892.202007064

Video：

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Objective To investigate the effectiveness of Vesselplasty and percutaneous kyphoplasty (PKP) in treatment of Kümmell disease.Methods Between January 2015 and December 2018, 63 patients with Kümmell disease were treated. Among them, 28 cases were treated with Vesselplasty (Vesselplasty group) and 35 cases were treated with PKP (PKP group). There was no significant difference in gender, age, disease duration, bone mineral density (T value), fracture distribution, and preoperative pain visual analogue scale (VAS) score, Oswestry Disability Index (ODI), anterior height of injured vertebrae, and kyphosis Cobb angle between the two groups (P>0.05). The operation time, intraoperative fluoroscopy time, bone cement injection volume, the leakage rate of bone cement, the diffusion area ratio of bone cement, and the complications of the two groups were recorded. VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle were compared between the two groups before operation and at 1 day after operation and last follow-up.Results All patients of the two groups were followed up 12-36 months, with an average of 24.2 months. The operation time, intraoperative fluoroscopy time, bone cement injection volume, and diffusion area ratio of bone cement were significantly lower in the Vesselplasty group than in the PKP group (P<0.05). The leakage rate of bone cement was significantly lower in the Vesselplasty group (7.14%) than in the PKP group (34.29%) (χ²=5.153, P=0.023). At 1 day after operation and last follow-up, the VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle of the two groups were superior to those before operation (P<0.05), and no significant difference between the two groups (P>0.05). During the follow-up, there was no re-collapse of vertebrae, and the adjacent vertebrae fracture occurred in 2 cases of the Vesselplasty group and 5 cases of PKP group. There was no significant difference in the incidence of adjacent vertebrae fracture between the Vesselplasty group (7.14%) and the PKP group (14.29%) (χ²=0.243, P=0.622).Conclusion Vesselplasty and PKP have similar effectiveness in the treatment of Kümmell disease. They can effectively relieve the pain symptoms, improve the quality of life, partially restore the height of injured vertebrae, and correct kyphosis. But the Vesselplasty has the advantages of shorter operation time, less intraoperative fluoroscopy time, and less bone cement leakage.

Citation： SUN Yuliang, XIONG Xiaoming, WAN Dun, DENG Xuangeng, SHI Huagang, SONG Simao, GU Tao, HOU Wei, ZHOU Jie. Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(12): 1539-1544. doi: 10.7507/1002-1892.202007064 Copy

1.	Formica M, Basso M, Cavagnaro L, et al. Kümmell disease: illustrative case for definition criteria. Spine J, 2016, 16(10): e707-e708.
2.	Feng SW, Chang MC, Wu HT, et al. Are intravertebral vacuum phenomena benign lesions? Eur Spine J, 2011, 20(8): 1341-1348.
3.	Park JW, Park JH, Jeon HJ, et al. Kümmell’s disease treated with percutaneous vertebroplasty: minimum 1 year follow-up. Korean J Neurotrauma, 2017, 13(2): 119-123.
4.	Xia YH, Chen F, Zhang L, et al. Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two-year follow-up. Exp Ther Med, 2018, 16(4): 3617-3622.
5.	李亮, 郝定均, 閆亮, 等. 紅外線主動誘導計算機輔助三維導航系統與普通 C 型臂 X 線機透視輔助經皮微創手術治療 Kümmell 病的比較研究. 中華創傷骨科雜志, 2019, 21(8): 658-664.
6.	Yeh KL, Wu SH, Wu SS, et al. Rare episode of cement leakage during vesselplasty in a case of vertebral compression fracture. World Neurosurg, 2020, 137: 416-420.
7.	He CJ, Liu GD. Comparison of the efficacy and safety of bone-filling mesh container and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Pain Physician, 2018, 21(3): 259-268.
8.	曹臣, 陳書連, 高延征, 等. 骨填充網袋單側穿刺經皮椎體成形術與經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折的療效比較. 中華創傷雜志, 2019, 35(1): 30-37.
9.	吳宏梓, 汪少波, 拉華欠, 等. 骨填充網袋術治療骨質疏松性椎體壓縮骨折療效與安全性的 Meta 分析. 中華創傷雜志, 2020, 36(5): 433-441.
10.	王智黔, 趙安菊, 彭智, 等. 骨填充網袋椎體成形術與經皮椎體后凸成形術治療老年骨質疏松性椎體壓縮骨折的療效比較. 中華創傷雜志, 2018, 34(7): 618-623.
11.	黃浩然, 馮麗, 梁華, 等. 骨填充網袋治療老年性骨質疏松性椎體壓縮骨折的特點. 中國組織工程研究, 2018, 22(26): 4110-4115.
12.	萬躉, 熊小明, 孫育良, 等. 單球囊雙側序貫擴張椎體后凸成形術預防復位椎體再塌陷. 中國矯形外科雜志, 2018, 26(18): 1658-1663.
13.	段自坤, 鄒晉峰, 康新國, 等. 骨填充網袋椎體成形術治療 Kümmell 病的效果. 中華麻醉學雜志, 2019, 39(11): 1334-1336.
14.	Duan ZK, Zou JF, He XL, et al. Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell’s disease. Arch Osteoporos, 2019, 14(1): 109.
15.	Piao M, Darwono AB, Zhu K. Extrapendicular approach of unilateral percutaneous vesselplasty for the treatment of Kummell disease. Int J Spine Surg, 2019, 13(2): 199-204.
16.	El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable device, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91: 628-632.
17.	唐海, 賈璞, 陳浩, 等. 新型 Vessel-X 經皮椎體強化系統在脊柱微創治療的臨床應用. 中華醫學雜志, 2017, 97(33): 2567-2572.
18.	何磊, 錢宇, 呂佐, 等. 明膠海綿碎屑預填注在椎體后凸成形術中預防骨水泥滲漏的作用. 中華骨科雜志, 2019, 39(19): 1173-1179.
19.	李馳, 王靖, 朱旻宇, 等. 經皮椎體成形二次骨水泥注射治療彌散不良的Kümmel病. 中國骨傷, 2019, 32(4): 308-313.

1. Formica M, Basso M, Cavagnaro L, et al. Kümmell disease: illustrative case for definition criteria. Spine J, 2016, 16(10): e707-e708.
2. Feng SW, Chang MC, Wu HT, et al. Are intravertebral vacuum phenomena benign lesions? Eur Spine J, 2011, 20(8): 1341-1348.
3. Park JW, Park JH, Jeon HJ, et al. Kümmell’s disease treated with percutaneous vertebroplasty: minimum 1 year follow-up. Korean J Neurotrauma, 2017, 13(2): 119-123.
4. Xia YH, Chen F, Zhang L, et al. Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two-year follow-up. Exp Ther Med, 2018, 16(4): 3617-3622.
5. 李亮, 郝定均, 閆亮, 等. 紅外線主動誘導計算機輔助三維導航系統與普通 C 型臂 X 線機透視輔助經皮微創手術治療 Kümmell 病的比較研究. 中華創傷骨科雜志, 2019, 21(8): 658-664.
6. Yeh KL, Wu SH, Wu SS, et al. Rare episode of cement leakage during vesselplasty in a case of vertebral compression fracture. World Neurosurg, 2020, 137: 416-420.
7. He CJ, Liu GD. Comparison of the efficacy and safety of bone-filling mesh container and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Pain Physician, 2018, 21(3): 259-268.
8. 曹臣, 陳書連, 高延征, 等. 骨填充網袋單側穿刺經皮椎體成形術與經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折的療效比較. 中華創傷雜志, 2019, 35(1): 30-37.
9. 吳宏梓, 汪少波, 拉華欠, 等. 骨填充網袋術治療骨質疏松性椎體壓縮骨折療效與安全性的 Meta 分析. 中華創傷雜志, 2020, 36(5): 433-441.
10. 王智黔, 趙安菊, 彭智, 等. 骨填充網袋椎體成形術與經皮椎體后凸成形術治療老年骨質疏松性椎體壓縮骨折的療效比較. 中華創傷雜志, 2018, 34(7): 618-623.
11. 黃浩然, 馮麗, 梁華, 等. 骨填充網袋治療老年性骨質疏松性椎體壓縮骨折的特點. 中國組織工程研究, 2018, 22(26): 4110-4115.
12. 萬躉, 熊小明, 孫育良, 等. 單球囊雙側序貫擴張椎體后凸成形術預防復位椎體再塌陷. 中國矯形外科雜志, 2018, 26(18): 1658-1663.
13. 段自坤, 鄒晉峰, 康新國, 等. 骨填充網袋椎體成形術治療 Kümmell 病的效果. 中華麻醉學雜志, 2019, 39(11): 1334-1336.
14. Duan ZK, Zou JF, He XL, et al. Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell’s disease. Arch Osteoporos, 2019, 14(1): 109.
15. Piao M, Darwono AB, Zhu K. Extrapendicular approach of unilateral percutaneous vesselplasty for the treatment of Kummell disease. Int J Spine Surg, 2019, 13(2): 199-204.
16. El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable device, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91: 628-632.
17. 唐海, 賈璞, 陳浩, 等. 新型 Vessel-X 經皮椎體強化系統在脊柱微創治療的臨床應用. 中華醫學雜志, 2017, 97(33): 2567-2572.
18. 何磊, 錢宇, 呂佐, 等. 明膠海綿碎屑預填注在椎體后凸成形術中預防骨水泥滲漏的作用. 中華骨科雜志, 2019, 39(19): 1173-1179.
19. 李馳, 王靖, 朱旻宇, 等. 經皮椎體成形二次骨水泥注射治療彌散不良的Kümmel病. 中國骨傷, 2019, 32(4): 308-313.

Chinese Journal of Reparative and Reconstructive Surgery

Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease

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