Clinical outcomes of short-segment cement-augmented pedicle screw fixation combined with vertebroplasty in patients with stage III Kummell's disease.

OBJECTIVE

This study evaluated the clinical utility of short-segment cement-augmented pedicle screw (SCAPS) fixation combined with vertebroplasty in patients with stage III Kummell's disease (KD).

METHODS

A retrospective analysis was conducted on 42 patients with stage III KD treated between January 2018 and December 2023. Frankel grades included C (n = 7), D (n = 15), and E (n = 20). All patients underwent SCAPS fixation with vertebroplasty. Perioperative variables, including operative duration and intraoperative blood loss, were recorded. Visual Analog Scale (VAS) pain scores, Oswestry Disability Index (ODI), anterior vertebral height (AVH), posterior vertebral height (PVH), Cobb angle, and Frankel grade were assessed preoperatively, one week postoperatively, and at the final follow-up. Complications were also documented.

RESULTS

All patients completed follow-up for 18 to 30 months (mean 24.52 ± 3.20 months). At one week postoperatively and at final follow-up, VAS, ODI, AVH, PVH, and Cobb angle demonstrated significant improvement relative to preoperative measurements (p < 0.05). At final follow-up, neurological function improved to Frankel grade E in 40 patients (95.2%). Asymptomatic cement leakage occurred in seven cases. Two adjacent vertebral fractures related to trauma were managed successfully with percutaneous kyphoplasty. No complications related to internal fixation were identified.

CONCLUSIONS

SCAPS fixation combined with vertebroplasty appears to be a safe and effective surgical approach for stage III KD, with significant correction of spinal kyphosis, restoration of vertebral height, improvement in neurological function, and maintenance of long-term spinal stability.