Treatment of Kümmell’s disease with sequential infusion of bone cement: A retrospective study

doi:10.12998/wjcc.v8.i23.5887

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World Journal of Clinical Cases

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Retrospective Study

World J Clin Cases. Dec 6, 2020; 8(23): 5887-5893
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.5887

Treatment of Kümmell’s disease with sequential infusion of bone cement: A retrospective study

Xing Zhang, Yong-Chao Li, Hong-Peng Liu, Bing Zhou, Hui-Lin Yang

Xing Zhang, Hui-Lin Yang, Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China

Xing Zhang, Hong-Peng Liu, Bing Zhou, Department of Orthopaedics, Gaoyou People’s Hospital Affiliated to Soochow University, Yangzhou 225600, Jiangsu Province, China

Yong-Chao Li, Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China

Author contributions: Zhang X and Li YC contributed equally to this work; Li YC, Zhou B and Yang HL designed research; Zhang X performed the surgery procedure; Li YC and Liu HP analyzed data; Zhang X, Li YC and Yang HL wrote the manuscript; All authors read and approved the final manuscript.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Gaoyou People’s Hospital Affiliated to Soochow University.

Informed consent statement: Informed written consent was obtained from the patients for publication of this manuscript and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at spineinchina@163.com. Participants gave informed consent for data sharing.

Corresponding author: Hui-Lin Yang, MD, PhD, Director, Doctor, Surgeon, Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. spineinchina@163.com

Received: April 10, 2020
Peer-review started: April 10, 2020
First decision: September 24, 2020
Revised: October 6, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: December 6, 2020
Processing time: 237 Days and 19.9 Hours

ARTICLE HIGHLIGHTS

Research background

Percutaneous vertebroplasty (PVP) is an effective method for the treatment of neurologically intact Kümmell’s disease, but bone cement leakage during surgery is a problem that deserves attention.

Research motivation

To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell’s disease.

Research objectives

To compare the clinical effect of sequential bone cement infusion and traditional bone cement infusion in the treatment of stage I or II Kümmell’s disease.

Research methods

Patients with Kümmell’s disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed. Patients meeting the inclusion and exclusion criteria were divided into two groups: Traditional single infusion (TSI group) and sequential infusion(SI group). The visual analog scale (VAS) and Oswestry disability index (ODI) were evaluated and compared, and duration of operation, bone cement content and complications were recorded.

Research results

Forty-five patients were included in this study, 24 in the TSI group and 21 in the SI group. The VAS and ODI were significantly different in both groups pre- and postoperatively. At the last follow-up, the VAS and ODI were not significantly different between the two groups compared with those at 1 wk postoperatively. The two groups had no significant differences in the VAS and ODI pre- and postoperatively and at the last follow-up. The leakage rate of bone cement was significantly lower in the SI group (14.3%, 3 of 21) than that in the TSI group (41.7%, 10 of 24).

Research conclusions

Sequential infusion in unipedicular PVP is a safe and effective procedure for neu-rologically intact Kümmell’s disease, and this technique could decrease the incidence of bone cement leakage.

Research perspectives

The role of sequential infusion in reducing the leakage of bone cement should be evaluated in a large sample multicenter randomized controlled study.