Clinical Efficacy of Percutaneous Kyphoplasty at the Hyperextension Position for the Treatment of Osteoporotic Kümmell Disease.

Abstract

Percutaneous kyphoplasty might be effective for osteoporotic Kümmell disease. To investigate the clinical efficacy of percutaneous kyphoplasty in hyperextension for osteoporotic Kümmell disease. Retrospective study. A retrospective analysis was carried out on data from downstream balloon kyphoplasty treatments in hyperextension for 18 patients with osteoporotic Kümmell disease. All cases were single-segment disease affecting T5 (1 case), T7 (1 case), T8 (2 cases), T11 (6 cases), T12 (4 cases), L1 (2 cases), L2 (1 case), or L4 (1 case). Dual-energy x-ray absorptiometry bone mineral density values ranged from -2.8 to -5.8 SD. The sagittal Cobb angle of the involved segment was measured before and after the operation and the final follow-up also included a visual analog pain score (VAS) and the Oswestry Disability Index (ODI) after comprehensive efficacy assessment. All patients were followed up for 12-36 months, with an average of 15.8 months. Patients showed lower back pain relief and improvement in daily life activities. The kyphosis Cobb angle improved from 32.60±3.82 degrees before surgery to 7.60±1.68 degrees after surgery, and VAS and ODI scores significantly improved from 8.7±0.96 points and 88.6±3.76% to 2.6±0.32 points and 28.6±2.67%, respectively. The last follow-up for the kyphosis Cobb angle yielded a value of 9.60±2.06 degrees, and VAS and ODI averaged 2.2±0.26 points and 26.4±2.46%, respectively. Compared with 2 days postoperatively, the differences were not statistically significant. Intervertebral cement leakage occurred in 1 case, but no symptom was observed and no treatment was performed. Percutaneous balloon kyphoplasty in the hyperextension position is an effective method for osteoporosis in Kümmell disease.