Percutaneous posterior short-segment pedicle screw fixation combined with vertebroplasty for stage III Kümmell's disease without neurological deficit

Objective To investigate the clinical efficacy of percutaneous posterior short-segment pedicle screw fixation combined with vertebroplasty for stage III Kummell's disease without neurological deficit. Methods A retrospective case series study was conducted to analyze the clinical data of 36 patients with stage III Kummell's disease without nerve injury admitted to Xiaoshan Hospital of Traditional Chinese Medicine from January 2012 to January 2017. There were 10 males and 26 females, aged 55-75 years, with an average of 67.5 years. The injuried vertebrae were located at T11 in 9 patients, at T12 in 12, at L1 in 10 and at L2 in 5. The course of disease ranged from 6 to 48 months, with an average of 28.5 months. X-ray, CT and MRI were performed before operation. All patients underwent percutaneous posterior short-segment pedicle screw fixation combined with vertebroplasty. The operation time, intraoperative bleeding volume, complications, visual analogue scale (VAS), Oswestry dysfunction index (ODI) and sagittal Cobb angle of the injured vertebrae were recorded before operation, 1 week after operation and at the last follow-up. Results All patients were followed up for an average of 32.5 months (range, 12-48 months). Operation time ranged from 0.6 to 1.5 hours[(1.1±0.4)hours]. The intraoperative blood loss was 50-90 ml [(62.5±17.5)ml]. There was no internal fixation failure or fracture of adjacent vertebra. The VAS was improved from preoperative (8.6±0.4)points to (2.5±0.7)points one week after operation and (2.9±0.7)points at the last follow-up (P<0.05). The ODI was improved from preoperative 68.2±3.9 to 22.7±4.3 one week after operation and 25.3±4.8 at the last follow-up (P<0.05). The Cobb angle was improved from preoperative (24.3±9.3)° to (8.6±3.2)° 1 week after operation and (10.5±4.1)° at the last follow-up (P<0.05). Conclusion For stage III Kummell's disease without neurological deficit, percutaneous posterior short-segment pedicle screw fixation combined with vertebroplasty can significantly relieve pain, improve spinal function and maintain spinal stability. Key words: Spinal fractures; Internal fixators; Vertebroplasty; Kummell's disease