Comparison of the clinical outcomes and cement distribution patterns after percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease and OVCFs

Abstract

Background The purpose of this study is to investigate and compare the therapeutic effect and distribution characteristics of bone cement in the PVP treatment for thoracolumbar Kümmell's diseases and OVCFs. Methods A prospective analysis of 35 patients with Kümmell ’s disease (K group) and 35 patients with OVCFs (O group) who underwent PVP treatment from February 2016 to February 2018 was conducted. The vertebral compression rate and degree of osteoporosis were more serious in the K group than in the O group ( P <0.05, respectively). Distribution pattern, volume and leakage rate of bone cement, operation time, VAS score, ODI, correction rates of vertebral compression and kyphosis, re-fracture rate of adjacent vertebrae in 2 years between the two groups were compared to assess clinical effect. Results The follow-up time of the two groups was 24-48 months. The amount of intraoperative bone cement injection was significantly higher in the K group than in the O group ( P =0.025). The cement distribution pattern of local solid lump was dominant in the K group (65.71%), while intercalation with trabeculae was dominant in the O group (74.29%) ( P <0.001). VAS score and ODI were significantly lower both in the two groups at 1 day, 1 year and 2 years after surgery than before surgery (all P <0.05), but significantly lower in the K group than in the O group at each time point after surgery (all P <0.05). The correction rates of kyphosis and vertebral compression in both groups was significantly corrected ( P <0.05, respectively) and gradually lost with time ( P <0.05, respectively). The correction rates of kyphosis and vertebral compression were significantly higher in the K group than in the O group at each time point after surgery (all P <0.05). Conclusions PVP has the advantages of simple operation, short operation time, small trauma and quick recovery in treating both Kümmell's disease and OVCFs. However, PVP can better restore partial vertebral height and correct kyphosis in the treatment of Kümmell's disease, while can better alleviate pain and improve ODI in the treatment of OVCFs.

Spine Surgical Robotics: Current Status and Recent Clinical Applications

“…18 Targeted puncture is an essential step in vertebroplasty and percutaneous transforaminal endoscopic discectomy (PTED), robotic assistance can obviously improve puncture accuracy. 19 Due to the fact that the anatomy of spinal tumor tissues is complex and the surgical field vision for tumor removal is limited, it is quite difficult to excise spinal tumor tissues completely, and avoid vascular and nerve damage. 20 The use of robotic visualization in clinical settings could markedly improve the success rate of complete tumor resection while minimizing trauma.…”

“…In recent years, the incidence of Kummell disease (KD) has increased gradually, vertebroplasty remains the mainstream treatment for KD, but this technique may cause a catastrophic complication of postoperative bone cement displacement. A comparison clinical study of RA versus conventional fluoroscopy-guided pediculoplasty combined with vertebroplasty in the treatment of patients with KD without neurological symptoms led by Wang et al 19 showed that the one-time success rate of RA puncture was up to 95.4%, RA pediculoplasty can effectively avoid bone cement displacement, lessen radiation exposure, achieve satisfactory vertebral body height restoration and kyphotic deformity improvement. With robot assistance, the first step of PVP, i.e., puncture can be performed precisely.…”