Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SUN Yuliang ,  XIONG Xiaoming , WAN Dun , DENG Xuangeng , SHI Huagang , SONG Simao , GU Tao , HOU Wei , ZHOU Jie

Department of Spine Surgery, Sichuan Provincial Orthopedics Hospital, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

XIONG Xiaoming, Email: 2841710476@qq.com

Keywords：

Vesselplasty; percutaneous kyphoplasty; Kümmell disease; bone cement leakage

DOI：

10.7507/1002-1892.202007064

Video：

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Objective To investigate the effectiveness of Vesselplasty and percutaneous kyphoplasty (PKP) in treatment of Kümmell disease.Methods Between January 2015 and December 2018, 63 patients with Kümmell disease were treated. Among them, 28 cases were treated with Vesselplasty (Vesselplasty group) and 35 cases were treated with PKP (PKP group). There was no significant difference in gender, age, disease duration, bone mineral density (T value), fracture distribution, and preoperative pain visual analogue scale (VAS) score, Oswestry Disability Index (ODI), anterior height of injured vertebrae, and kyphosis Cobb angle between the two groups (P>0.05). The operation time, intraoperative fluoroscopy time, bone cement injection volume, the leakage rate of bone cement, the diffusion area ratio of bone cement, and the complications of the two groups were recorded. VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle were compared between the two groups before operation and at 1 day after operation and last follow-up.Results All patients of the two groups were followed up 12-36 months, with an average of 24.2 months. The operation time, intraoperative fluoroscopy time, bone cement injection volume, and diffusion area ratio of bone cement were significantly lower in the Vesselplasty group than in the PKP group (P<0.05). The leakage rate of bone cement was significantly lower in the Vesselplasty group (7.14%) than in the PKP group (34.29%) (χ²=5.153, P=0.023). At 1 day after operation and last follow-up, the VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle of the two groups were superior to those before operation (P<0.05), and no significant difference between the two groups (P>0.05). During the follow-up, there was no re-collapse of vertebrae, and the adjacent vertebrae fracture occurred in 2 cases of the Vesselplasty group and 5 cases of PKP group. There was no significant difference in the incidence of adjacent vertebrae fracture between the Vesselplasty group (7.14%) and the PKP group (14.29%) (χ²=0.243, P=0.622).Conclusion Vesselplasty and PKP have similar effectiveness in the treatment of Kümmell disease. They can effectively relieve the pain symptoms, improve the quality of life, partially restore the height of injured vertebrae, and correct kyphosis. But the Vesselplasty has the advantages of shorter operation time, less intraoperative fluoroscopy time, and less bone cement leakage.

Citation： SUN Yuliang, XIONG Xiaoming, WAN Dun, DENG Xuangeng, SHI Huagang, SONG Simao, GU Tao, HOU Wei, ZHOU Jie. Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(12): 1539-1544. doi: 10.7507/1002-1892.202007064 Copy

1.	Formica M, Basso M, Cavagnaro L, et al. Kümmell disease: illustrative case for definition criteria. Spine J, 2016, 16(10): e707-e708.
2.	Feng SW, Chang MC, Wu HT, et al. Are intravertebral vacuum phenomena benign lesions? Eur Spine J, 2011, 20(8): 1341-1348.
3.	Park JW, Park JH, Jeon HJ, et al. Kümmell’s disease treated with percutaneous vertebroplasty: minimum 1 year follow-up. Korean J Neurotrauma, 2017, 13(2): 119-123.
4.	Xia YH, Chen F, Zhang L, et al. Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two-year follow-up. Exp Ther Med, 2018, 16(4): 3617-3622.
5.	李亮, 郝定均, 闫亮, 等. 红外线主动诱导计算机辅助三维导航系统与普通 C 型臂 X 线机透视辅助经皮微创手术治疗 Kümmell 病的比较研究. 中华创伤骨科杂志, 2019, 21(8): 658-664.
6.	Yeh KL, Wu SH, Wu SS, et al. Rare episode of cement leakage during vesselplasty in a case of vertebral compression fracture. World Neurosurg, 2020, 137: 416-420.
7.	He CJ, Liu GD. Comparison of the efficacy and safety of bone-filling mesh container and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Pain Physician, 2018, 21(3): 259-268.
8.	曹臣, 陈书连, 高延征, 等. 骨填充网袋单侧穿刺经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效比较. 中华创伤杂志, 2019, 35(1): 30-37.
9.	吴宏梓, 汪少波, 拉华欠, 等. 骨填充网袋术治疗骨质疏松性椎体压缩骨折疗效与安全性的 Meta 分析. 中华创伤杂志, 2020, 36(5): 433-441.
10.	王智黔, 赵安菊, 彭智, 等. 骨填充网袋椎体成形术与经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的疗效比较. 中华创伤杂志, 2018, 34(7): 618-623.
11.	黄浩然, 冯丽, 梁华, 等. 骨填充网袋治疗老年性骨质疏松性椎体压缩骨折的特点. 中国组织工程研究, 2018, 22(26): 4110-4115.
12.	万趸, 熊小明, 孙育良, 等. 单球囊双侧序贯扩张椎体后凸成形术预防复位椎体再塌陷. 中国矫形外科杂志, 2018, 26(18): 1658-1663.
13.	段自坤, 邹晋峰, 康新国, 等. 骨填充网袋椎体成形术治疗 Kümmell 病的效果. 中华麻醉学杂志, 2019, 39(11): 1334-1336.
14.	Duan ZK, Zou JF, He XL, et al. Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell’s disease. Arch Osteoporos, 2019, 14(1): 109.
15.	Piao M, Darwono AB, Zhu K. Extrapendicular approach of unilateral percutaneous vesselplasty for the treatment of Kummell disease. Int J Spine Surg, 2019, 13(2): 199-204.
16.	El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable device, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91: 628-632.
17.	唐海, 贾璞, 陈浩, 等. 新型 Vessel-X 经皮椎体强化系统在脊柱微创治疗的临床应用. 中华医学杂志, 2017, 97(33): 2567-2572.
18.	何磊, 钱宇, 吕佐, 等. 明胶海绵碎屑预填注在椎体后凸成形术中预防骨水泥渗漏的作用. 中华骨科杂志, 2019, 39(19): 1173-1179.
19.	李驰, 王靖, 朱旻宇, 等. 经皮椎体成形二次骨水泥注射治疗弥散不良的Kümmel病. 中国骨伤, 2019, 32(4): 308-313.

1. Formica M, Basso M, Cavagnaro L, et al. Kümmell disease: illustrative case for definition criteria. Spine J, 2016, 16(10): e707-e708.
2. Feng SW, Chang MC, Wu HT, et al. Are intravertebral vacuum phenomena benign lesions? Eur Spine J, 2011, 20(8): 1341-1348.
3. Park JW, Park JH, Jeon HJ, et al. Kümmell’s disease treated with percutaneous vertebroplasty: minimum 1 year follow-up. Korean J Neurotrauma, 2017, 13(2): 119-123.
4. Xia YH, Chen F, Zhang L, et al. Percutaneous kyphoplasty treatment evaluation for patients with Kümmell disease based on a two-year follow-up. Exp Ther Med, 2018, 16(4): 3617-3622.
5. 李亮, 郝定均, 闫亮, 等. 红外线主动诱导计算机辅助三维导航系统与普通 C 型臂 X 线机透视辅助经皮微创手术治疗 Kümmell 病的比较研究. 中华创伤骨科杂志, 2019, 21(8): 658-664.
6. Yeh KL, Wu SH, Wu SS, et al. Rare episode of cement leakage during vesselplasty in a case of vertebral compression fracture. World Neurosurg, 2020, 137: 416-420.
7. He CJ, Liu GD. Comparison of the efficacy and safety of bone-filling mesh container and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Pain Physician, 2018, 21(3): 259-268.
8. 曹臣, 陈书连, 高延征, 等. 骨填充网袋单侧穿刺经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效比较. 中华创伤杂志, 2019, 35(1): 30-37.
9. 吴宏梓, 汪少波, 拉华欠, 等. 骨填充网袋术治疗骨质疏松性椎体压缩骨折疗效与安全性的 Meta 分析. 中华创伤杂志, 2020, 36(5): 433-441.
10. 王智黔, 赵安菊, 彭智, 等. 骨填充网袋椎体成形术与经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的疗效比较. 中华创伤杂志, 2018, 34(7): 618-623.
11. 黄浩然, 冯丽, 梁华, 等. 骨填充网袋治疗老年性骨质疏松性椎体压缩骨折的特点. 中国组织工程研究, 2018, 22(26): 4110-4115.
12. 万趸, 熊小明, 孙育良, 等. 单球囊双侧序贯扩张椎体后凸成形术预防复位椎体再塌陷. 中国矫形外科杂志, 2018, 26(18): 1658-1663.
13. 段自坤, 邹晋峰, 康新国, 等. 骨填充网袋椎体成形术治疗 Kümmell 病的效果. 中华麻醉学杂志, 2019, 39(11): 1334-1336.
14. Duan ZK, Zou JF, He XL, et al. Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell’s disease. Arch Osteoporos, 2019, 14(1): 109.
15. Piao M, Darwono AB, Zhu K. Extrapendicular approach of unilateral percutaneous vesselplasty for the treatment of Kummell disease. Int J Spine Surg, 2019, 13(2): 199-204.
16. El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable device, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91: 628-632.
17. 唐海, 贾璞, 陈浩, 等. 新型 Vessel-X 经皮椎体强化系统在脊柱微创治疗的临床应用. 中华医学杂志, 2017, 97(33): 2567-2572.
18. 何磊, 钱宇, 吕佐, 等. 明胶海绵碎屑预填注在椎体后凸成形术中预防骨水泥渗漏的作用. 中华骨科杂志, 2019, 39(19): 1173-1179.
19. 李驰, 王靖, 朱旻宇, 等. 经皮椎体成形二次骨水泥注射治疗弥散不良的Kümmel病. 中国骨伤, 2019, 32(4): 308-313.

Chinese Journal of Reparative and Reconstructive Surgery

Comparison of effectiveness of Vesselplasty and percutaneous kyphoplasty for Kümmell disease

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