Cement augmented anterior reconstruction with short posterior instrumentation: A less invasive surgical option for Kummell’s disease with cord compression

Lee, Sun-Ho; Kim, Eun Sang; Eoh, Whan

doi:10.1016/j.jocn.2010.07.139

Cited by 60 publications

(80 citation statements)

References 24 publications

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“…As expected, the patient's lower back pain was signi cantly relieved, and 10 patients with signi cant nerve injury had a signi cant improvement in postoperative AISA grade. Our results are also consistent with previous reports [3,19]. Part IV patients had local instability of the vertebral body, and the biomechanics of the spine was destroyed.…”

Section: Discussionsupporting

confidence: 93%

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Zhou

Hao

Dong

et al. 2020

Preprint

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Background As the population ages, osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. Therefore, the aim of our study was to investigate the treatment of symptomatic old osteoporotic vertebral compression fractures. Methods A retrospective study was designed to enroll patients with symptomatic old OVCFs from June 2013 to 2016. According to the complexity of the disease, the patients were divided into I to V grades, and the surgical methods were developed according to the grades. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results VAS score, ODI score and SI of all patients were significantly improved as compared with that before surgery, and the results of the final follow-up were statistically significant in comparison to preoperative outcome (P˂0.05). All the 16 patients with nerve injury showed significant improvement after surgery. The AISA grade were improved from grade C (14 cases), grade D (2 case) to grade D (4 cases) and grade E (12 cases). Conclusion Old OVCFs are difficult to treat. Graded surgery can better restore spinal stability and improve clinical outcomes.

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Section: Discussionsupporting

confidence: 93%

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Zhou

Hao

Dong

et al. 2020

Preprint

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“…However, this method requires relatively high-level surgical skills and a long learning curve [25]. us, for this condition, some scholars have recently recommended PFVP, a relatively simple and minimally invasive approach that does not need to address the anterior lesion [20,26]. Lee et al [26] showed that PFVP is an effective treatment for OVCFs with IVC complicated by neurologic symptoms; however, the authors observed an average 4.5°loss of correction in the kyphotic angle at the final follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…e vertebral height was measured as the height of the anterior and posterior margins of the diseased vertebral body (anterior vertebral height (AVH) and posterior vertebral height (PVH)) as described by Lee et al [26]. e AVH, PVH, and LKA were assessed before and after surgery ( Figure 1).…”

Section: Radiological and Clinical Evaluationmentioning

confidence: 99%

“…Although a few studies have confirmed that vertebroplasty could be an alternative intervention for the effective and safe treatment of OVCFs with IVC complicated by neurological deficits, patients with low intravertebral stability and severe spinal cord injuries should be considered candidates for reconstructive surgery [19]. Currently, several open surgery options, mainly consisting of posterior fixation combined with vertebroplasty (PFVP) or vertebral column resection (PVCR) for IVC complicated by neurological deficits, have been reported in the literature [20,[24][25][26]. However, the preferred surgical option remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Posterior Fixation Combined with Vertebroplasty or Vertebral Column Resection for the Treatment of Osteoporotic Vertebral Compression Fractures with Intravertebral Cleft Complicated by Neurological Deficits

Wei

Dong

Zhu

2019

BioMed Research International

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Purpose. The aim of the current study was to evaluate the relative benefits of posterior fixation combined with vertebroplasty (PFVP) or vertebral column resection (PVCR) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) complicated by neurological deficits. Methods. From June 2010 to January 2015, 45 consecutive patients suffering OVCFs with IVC and spinal cord injuries were treated with PFVP or PVCR in our department. The visual analogue scale (VAS) score, anterior vertebral height (AVH), posterior vertebral height (PVH), local kyphotic angle (LKA), and neurologic function were evaluated and compared, and the operative duration, blood loss, and complications were also recorded. Results. They all achieved excellent pain relief, vertebral height recovery, and kyphosis correction one month after surgery, and no significant differences existed between the two groups. No significant differences were observed between the 1-month postoperative and final follow-up VAS, AVH, and LKA values in the PVCR group (P>0.05), while AVH and LKA worsened in the PFVP group at the final follow-up (P<0.05). Similarly, the initial improvements in VAS scores decreased over time (P<0.05). Neurologic function improved in both groups, and no significant differences were observed between the 2 groups either preoperatively or postoperatively (P>0.05). The blood loss and operative duration were significantly lower in the PFVP group than those in the PVCR group (P<0.05). Conclusion. Compared with PVCR, PFVP had equivalent short-term clinical outcomes with less blood loss and operative duration which can be very beneficial for treating elderly patients with extreme comorbidities in this condition. However, based on the long-term efficacy of pain relief, vertebral height maintenance, and deformity correction, PVCR is a more reasonable choice.

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“…26,27 The disease progresses progressively, and due to the obvious vertebral body necrosis and collapse, it can lead to severe kyphotic deformity in the late stage, which has a higher incidence of nerve injury than common OVCF. 28,29 Li et al divided Kümmell's disease into three stages: in Stage I, vertebral body height reduction was < 20% without adjacent disc degeneration; in Stage II, vertebral body height reduction was > 20%, often with adjacent disc degeneration; in Stage III, the posterior cortex of vertebrae ruptured with spinal cord compression. 19 For stages I and II, PVP and PKP procedures are often used for vertebral bone cement treatment.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous vertebroplasty versus percutaneous kyphoplasty for the treatment of delayed post-traumatic vertebral body collapse (Kümmell’s disease) in Chinese patients: a systematic review and meta-analysis

Han

Chen

et al. 2019

Frontiers of Nursing

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Objective To compare the clinical efficacy between percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of Kümmell’s disease in Chinese patients. Methods The studies using randomized controlled trials to compare clinical efficacy between PVP and PKP in the treatment of Kümmell’s disease in Chinese patients were retrieved from Embase, Pubmed, Central, Cinahl, PQDT, CNKI, CQVIP, Wanfang Data, and CBM (from September 2008 to September 2018). Keywords for both Chinese and English search were: percutaneous vertebroplasty, PVP, percutaneous kyphoplasty, PKP, and Kümmell’s disease. A total of 132 articles were retrieved based on the search strategy through online database searching and manual searching. Finally, one foreign report and seven Chinese reports were included. After extracting the data, statistical software Review Manager 5.3 was used for data analysis. Results Through comparison, Cobb angle (95% CI [0.54, 4.42), P = 0.01] and Oswestry Dysfunction Index (ODI) (95% CI [0.21, 2.15], P= 0.02) of PKP group was smaller than that of PVP group. Postoperative anterior vertebral body height of the PKP group was better than PVP group (95% CI [−1.27, −0.66], P < 0.001]. However, the PVP group had shorter operation time than PKP group (95% CI [−13.48, −7.43), P = 0.001]. In the other outcome measures, including Visual Analogue Scale (VAS) score (95% CI [−0.04, 0.27), P = 0.15), cement volume (95% CI [−0.82, 0.32], P = 0.39) and cement leakage (95% CI [0.90, 2.76], P = 0.11), there was no significant differences between the two procedures. Conclusions At this stage, there is sufficient evidence to support that PKP is better than PVP in the treatment of Kümmell’s disease in Chinese patients. Although PVP surgery requires much less operation time, PKP has better postoperative radiological results and lower ODI. Moreover, both of them had similar clinical results (e.g., analgesic effects, cement dosage, and leakage rate). Further evidence is dependent on the emergence of randomized controlled trials with higher quality and larger sample sizes in the future.

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Cement augmented anterior reconstruction with short posterior instrumentation: A less invasive surgical option for Kummell’s disease with cord compression

Cited by 60 publications

References 24 publications

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Selection of surgical treatment approaches for old osteoporotic vertebral compression fractures: A Retrospective Study of 238 Cases

Posterior Fixation Combined with Vertebroplasty or Vertebral Column Resection for the Treatment of Osteoporotic Vertebral Compression Fractures with Intravertebral Cleft Complicated by Neurological Deficits

Percutaneous vertebroplasty versus percutaneous kyphoplasty for the treatment of delayed post-traumatic vertebral body collapse (Kümmell’s disease) in Chinese patients: a systematic review and meta-analysis

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