title: [Percutaneous kyphoplasty in hyperextension position for treatment of middle and late period Kümmell disease].
abstract: OBJECTIVE
  To evaluate the feasibility and effectiveness of percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease.
  
  
  METHODS
  Between May 2003 and February 2009, 17 patients with Kümmell disease (6 at stage II, 11 at stage III) were treated with percutaneous kyphoplasty in hyperextension position. There were 5 males and 12 females with an average age of 71 years (range, 55-85 years). The involved vertebral bodies were T10 in 1 case, T11 in 3 cases, T12 in 7 cases, L1 in 4 cases, L2 in 1 case, and T12, L1 in 1 case by X-ray, CT, and MRI examinations. The effectiveness was determined by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The height and the kyphotic Cobb angle of the involved vertebral body were measured pre- and postoperatively.
  
  
  RESULTS
  The operation was successfully completed in all the patients, and the incisions healed by first intention. Pain was alleviated or eliminated within 48 hours after operation; no spinal nerves injury or pulmonary embolism occurred. One patient had cement leakage to the adjacent disc, who did not manifest any clinical symptoms. Thirteen patients were followed up 24 to 56 months (mean, 32 months). The VAS score, ODI, anterior and medial vertebral height, kyphotic Cobb angle of involved vertebral body were improved significantly at 1 week after operation and at last follow-up (P < 0.05), there was no significant difference between at 1 week after operation and at last follow-up (P > 0.05). Adjacent vertebral fracture occurred in 1 patient at 6 months after operation and was cured after percutaneous kyphoplasty.
  
  
  CONCLUSIONS
  Percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease can relieve back pain, improve viability, decrease Cobb angle, and retain the vertebral body height and spinal alignment. The general condition of the patient is needed to be evaluated and the operation indication should be controlled strictly.
authors.affiliation: Department of Orthopedic Surgery, Jiangyin Hospital, Southeast University, Jiangyin Jiangsu, 214400, P.R. China.
authors.forename: Yunqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Huiguang
authors.initials: H
authors.lastname: Yang
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.forename: Xiongwei
authors.initials: X
authors.lastname: Deng
authors.forename: Wenxing
authors.initials: W
authors.lastname: Luo
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000473:pathology / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D010147:Pain Measurement; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery*; D016103:Spinal Fractures / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome