Comparison of the Percutaneous Kyphoplasty "Trinity" Anchoring Technique versus Conventional Percutaneous Kyphoplasty for Kummell Disease: A Retrospective Observational Study.

Abstract

To compare the clinical efficacy and radiological outcomes of the novel percutaneous kyphoplasty (PKP) "Trinity" anchoring technique versus conventional PKP for Kummell disease. We retrospectively analyzed 92 patients (January 2019-January 2024) assigned to the PKP "Trinity" (n = 45) or conventional PKP (n = 47) groups. The "Trinity" technique used a bilateral, O-arm-guided approach to construct a continuous cement anchoring complex across the vertebral body, pedicle, and articular process. Perioperative metrics, clinical outcomes, and complications were compared. Baseline characteristics, operative time, and leakage rates were similar between groups (P > 0.05). The Trinity group required significantly higher cement volume (P < 0.05). While immediate postoperative improvements in visual analog scale, Oswestry Disability Index, and radiographic parameters were comparable (P > 0.05), the Trinity group demonstrated superior outcomes regarding pain relief, functional recovery, and vertebral height maintenance at 3 months and final follow-up (P < 0.05). Crucially, the incidence of cement loosening was significantly lower in the Trinity group compared to conventional PKP (2.2% vs. 17.0%, P < 0.05). While immediate relief is comparable, the PKP "Trinity" technique demonstrates superior mid-term to long-term clinical and radiographic stability. By establishing a robust three-column integrated anchoring complex, this technique significantly mitigates the risk of cement loosening, presenting a safer and more effective alternative for stage I and II Kummell disease.