Assessment of Bilateral Pedicle Root Puncture Vertebral Fissure Expansion Percutaneous Kyphoplasty for the Treatment of Kümmell Disease.

Abstract

Retrospective analysis of clinical efficacy. To assess the clinical efficacy of bilateral pedicle root puncture vertebral fissure expansion percutaneous kyphoplasty (PKP) in the treatment of Kümmell disease (KD). KD is a challenging condition characterized by delayed healing of a vertebral compression fracture, often leading to chronic pain and disability. Traditional treatments may not provide optimal outcomes, necessitating new interventional approaches. A retrospective analysis was conducted on 56 patients, each with a single vertebra affected by KD. The bilateral pedicle root puncture vertebral fissure expansion PKP technique was used to treat these patients. In this procedure, a balloon was used to expand the vertebral fissure at the interface between the fissure within the vertebral body and the adjacent cancellous bone, facilitating the anchoring of bone cement at this junction. This allowed for the diffusion of cement into the fissure cavity and surrounding areas. Surgical outcomes were systematically observed and documented, including assessments of pain levels, quality of life, and vertebral recovery both preoperatively and postoperatively at intervals of 1 day, 3 months, 6 months, and 12 months. All patients exhibited significant improvement in clinical status and imaging outcomes, with no indications of cement loosening or displacement. Significant alleviation of back pain symptoms was observed, as demonstrated by reductions in scores on the visual analog scale (VAS) and Oswestry disability index (ODI), along with improved anterior vertebral body height, wedging angle, hyperextension segmental angle, and Cobb angle at both postoperative and final follow-up assessments (P<0.05). The application of bilateral pedicle root puncture vertebral fissure expansion PKP in treating KD reduces the risks associated with cement leakage, displacement, and loosening. This technique achieves an extensive and 3-dimensional distribution of cement, thereby enhancing the stability of the fractured vertebrae.