BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,acco...BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,accompanying vertebral rotational deformities make surgical procedures challenging risky.Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them.We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty(PKP)under O-arm guidance.CASE SUMMARY An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall.She was diagnosed with Kümmell disease based on physical and radiologic examinations.The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty,resulting in a significant alleviation of low back pain.CONCLUSION PKP has good efficacy in treating Kümmell disease.However,surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine.O-arm assisted operations play a crucial role in decreasing surgical risks.展开更多
BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To r...BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell’s disease.METHODS Patients with Kümmell’s disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed.Patients meeting the inclusion and exclusion criteria were divided into two groups:Traditional single infusion and sequential infusion(SI).The visual analog scale(VAS)and Oswestry disability index(ODI)were evaluated and compared,and duration of operation,bone cement content and complications were recorded.RESULTS Forty-five patients were included in this study;there were 24 in the traditional single infusion group and 21 in the SI group.The VAS and ODI were significantly different for both groups when compared pre-and postoperatively,whereas the differences between 1 wk postoperatively and at the final follow-up were not statistically.When the VAS and ODI of the two groups were compared,there were no significant differences at any time point.The leakage rate of bone cement was significantly lower in the SI group(14.3%,3 of 21)than that in the traditional single infusion group(41.7%,10 of 24).CONCLUSION SI in unipedicular PVP is a safe and effective procedure for neurologically intact Kümmell’s disease,and this technique could decrease the incidence of bone cement leakage.展开更多
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 rand...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.展开更多
基金Supported by The Innovation and Entrepreneurship Program of Jiangsu Province,No.(2015)-159。
文摘BACKGROUND Due to mechanical imbalance in the spine,elderly scoliosis patients tend to develop vertebral fracture nonunion,i.e.,Kümmell disease,when osteoporotic vertebral compression fractures occur.However,accompanying vertebral rotational deformities make surgical procedures challenging risky.Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them.We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty(PKP)under O-arm guidance.CASE SUMMARY An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall.She was diagnosed with Kümmell disease based on physical and radiologic examinations.The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty,resulting in a significant alleviation of low back pain.CONCLUSION PKP has good efficacy in treating Kümmell disease.However,surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine.O-arm assisted operations play a crucial role in decreasing surgical risks.
文摘BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell’s disease.METHODS Patients with Kümmell’s disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed.Patients meeting the inclusion and exclusion criteria were divided into two groups:Traditional single infusion and sequential infusion(SI).The visual analog scale(VAS)and Oswestry disability index(ODI)were evaluated and compared,and duration of operation,bone cement content and complications were recorded.RESULTS Forty-five patients were included in this study;there were 24 in the traditional single infusion group and 21 in the SI group.The VAS and ODI were significantly different for both groups when compared pre-and postoperatively,whereas the differences between 1 wk postoperatively and at the final follow-up were not statistically.When the VAS and ODI of the two groups were compared,there were no significant differences at any time point.The leakage rate of bone cement was significantly lower in the SI group(14.3%,3 of 21)than that in the traditional single infusion group(41.7%,10 of 24).CONCLUSION SI in unipedicular PVP is a safe and effective procedure for neurologically intact Kümmell’s disease,and this technique could decrease the incidence of bone cement leakage.
基金supported by National Project of International Science and technology Cooperation program of China(No.2015DFA33050)National Natural Science Foundation of China for Youths(No.81601949)
文摘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.
