[Percutaneous kyphoplasty in hyperextension position for treatment of middle and late period Kümmell disease].

OBJECTIVE

To evaluate the feasibility and effectiveness of percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease.

METHODS

Between May 2003 and February 2009, 17 patients with Kümmell disease (6 at stage II, 11 at stage III) were treated with percutaneous kyphoplasty in hyperextension position. There were 5 males and 12 females with an average age of 71 years (range, 55-85 years). The involved vertebral bodies were T10 in 1 case, T11 in 3 cases, T12 in 7 cases, L1 in 4 cases, L2 in 1 case, and T12, L1 in 1 case by X-ray, CT, and MRI examinations. The effectiveness was determined by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The height and the kyphotic Cobb angle of the involved vertebral body were measured pre- and postoperatively.

RESULTS

The operation was successfully completed in all the patients, and the incisions healed by first intention. Pain was alleviated or eliminated within 48 hours after operation; no spinal nerves injury or pulmonary embolism occurred. One patient had cement leakage to the adjacent disc, who did not manifest any clinical symptoms. Thirteen patients were followed up 24 to 56 months (mean, 32 months). The VAS score, ODI, anterior and medial vertebral height, kyphotic Cobb angle of involved vertebral body were improved significantly at 1 week after operation and at last follow-up (P < 0.05), there was no significant difference between at 1 week after operation and at last follow-up (P > 0.05). Adjacent vertebral fracture occurred in 1 patient at 6 months after operation and was cured after percutaneous kyphoplasty.

CONCLUSION

Percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease can relieve back pain, improve viability, decrease Cobb angle, and retain the vertebral body height and spinal alignment. The general condition of the patient is needed to be evaluated and the operation indication should be controlled strictly.