Acta Orthopaedica et Traumatologica Turcica
Research Article

Short-term outcomes of percutaneous pedicle screw fixation combined with vertebroplasty: A minimally invasive treatment for Kümmell’s disease with intravertebral instability

1.

Department of Orthopaedic Surgery, Lishui Hospital of Zhejiang University, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Zhejiang, People’s Republic of China

AOTT 2020; 54: 627-633
DOI: 10.5152/j.aott.2020.19245
Read: 99 Downloads: 32 Published: 30 December 2020

Objective: The aim of this study was to present early clinical and radiological outcomes of percutaneous pedicle screw fixation (PPSF) combined with vertebroplasty (VP) in the treatment of Kümmell’s disease with intravertebral instability.

Methods: In this study, 21 consecutive patients (4 male and 17 female; mean age = 75.6 years; age range=65-86 years) who suffered from stage II and III Kümmell’s disease with intravertebral instability were prospectively recruited from 2012 to 2016 and treated with PPSF combined with VP. The Cobb angle (CA) or wedge angle (WA) in both flexion and extension positions was measured using lateral radiographs, computed tomography, or magnetic resonance imaging. In addition to these radiological parameters, clinical outcome measures, including the visual analog scale (VAS) and the Oswestry Disability Index (ODI) were collected preoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and then annually. Complications were also recorded.

Results: The mean follow-up was 19.3 (range=12-36) months. The mean operating time was 135.4 (range, 110-175) min, and the mean estimated blood loss was 106.9 (range, 50-165) mL. The mean VAS score and ODI significantly decreased from 7.7±1.1 and 65.3%±7.7% preoperatively to 3.4±0.6 and 30.0%±7.6% postoperatively, respectively (p<0.05). At the final follow-up, the mean VAS score and ODI were 2.5±0.8 and 21.5%±8.8%, respectively (p>0.05). CA and WA significantly decreased from 26.9°±9.7° and 21.3°±6.0° preoperatively to 12.7°±7.2° to 8.6°±4.5° postoperatively, respectively (p<0.05). At the final follow-up, CA was 4.2°±2.0°, and WA was 4.7°±1.8° (p>0.05). No major complications were encountered during the follow-up period.

Conclusion: PPSF combined with VP seems to be an effective surgical option for the treatment of Kümmell’s disease with intravertebral instability.

Level of Evidence: Level IV, Therapeutic study

Cite this article as: Lou C, Yu W, Chen Z, Gao J, Liu F, He D. Short-term outcomes of percutaneous pedicle screw fixation combined with vertebroplasty: A minimally invasive treatment for Kümmell’s disease with intravertebral instability. Acta Orthop Traumatol Turc 2020; 54(6): 627-33.

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ISSN 1017-995X EISSN 2589-1294