Open AccessPercutaneous Kyphoplasty for Kummell Disease with Severe Spinal Canal Stenosis
Author(s) -
Yan Yang
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2015/18/e1021
Subject(s) - medicine , oswestry disability index , visual analogue scale , stenosis , surgery , retrospective cohort study , percutaneous , spinal canal stenosis , spinal stenosis , spinal canal , back pain , radiography , low back pain , radiology , lumbar , spinal cord , psychiatry , alternative medicine , pathology
Background: Percutaneous kyphoplasty (PKP) has been proven as an effective, minimallyinvasive procedure for the treatment of Kummell’s disease in the early stages. However, a riskof cement leakage and further neurological damage remains during and after PKP, especially inchronic osteoporotic stage III Kummell’s disease with severe spinal canal stenosis.Objective: To evaluate the feasibility and efficacy of PKP for the treatment of chronicosteoporotic stage III Kummell’s disease with severe spinal canal stenosis.Study Design: A retrospective evaluation of postoperative radiographs.Setting: Pain management clinic.Methods: A retrospective study was performed on 9 patients with 11 levels managed with PKPfor chronic osteoporotic stage III Kummell’s disease with severe spinal canal stenosis. Clinical andradiological outcomes were assessed.Results: Substantial pain relief was attained in all the patients. Both visual analogue scale (VAS)and Oswestry Disability Index (ODI) scores improved significantly from pre- to post-operation (P< 0.05), and remained unchanged at every follow-up. No neurological deterioration was found.Postoperatively, the anterior and midline vertebral body heights were significantly corrected (P< 0.05), and were sustained at the final follow-up. Similar results were seen in the correctionof kyphotic angle. Neither cement leakage into the spinal canal nor further dislodging of theposterior vertebral fragments occurred. Two cases experienced subsequent fractures with onehaving a second PKP and the other being treated conservatively.Limitations: Retrospective study of 9 cases with 11 levels due partly to the rarity of the disorder.Conclusions: PKP is an effective, minimally invasive procedure for the treatment of chronicosteoporotic stage III Kummell’s disease with severe spinal stenosis, leading to a significant reliefof symptoms and improvement of functional status.Institutional Review: This study was approved by the Institutional Review Board.Key words: Kummell’s disease, kyphoplasty, spine, osteoporosis, cement leakage,polymethylmethacrylate, neurological deficits, burst fractures