Bone Cement-Augmented Percutaneous Short Segment Fixation: An Effective Treatment for Kummell's Disease?
OBJECTIVE
The aim of this prospective study was to evaluate the efficacy of bone cement-augmented percutaneous short segment fixation for treating Kummell's disease accompanied by severe osteoporosis.


METHODS
From 2009 to 2013, ten patients with single-level Kummell's disease accompanied by severe osteoporosis were enrolled in this study. After postural reduction for 1-2 days, bone cement-augmented percutaneous short segment fixation was performed at one level above, one level below, and at the collapsed vertebra. Clinical results, radiological parameters, and related complications were assessed preoperatively and at 1 month and 12 months after surgery.


RESULTS
Prior to surgery, the mean pain score on the visual analogue scale was 8.5±1.5. One month after the procedure, this score improved to 2.2±2.0 and the improvement was maintained at 12 months after surgery. The mean preoperative vertebral height loss was 48.2±10.5%, and the surgical procedure reduced this loss to 22.5±12.4%. In spite of some recurrent height loss, significant improvement was achieved at 12 months after surgery compared to preoperative values. The kyphotic angle improved significantly from 22.4±4.9° before the procedure to 10.1±3.8° after surgery and the improved angle was maintained at 12 months after surgery despite a slight correction loss. No patient sustained adjacent fractures after bone cement-augmented percutaneous short segment fixation during the follow-up period. Asymptomatic cement leakage into the paravertebral area was observed in one patient, but no major complications were seen.


CONCLUSIONS
Bone cement-augmented percutaneous short segment fixation can be an effective and safe procedure for Kummell's disease.
Department of Natural Medical Sciences, College of Health Science, Chosun University, Gwangju, Korea.
Seon Joo
SJ
Park
Department of Neurosurgery, Sun Han Hospital, Gwangju, Korea.
Hyeun Sung
HS
Kim
Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chosun University, Gwangju, Korea.
Seok Ki
SK
Lee
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Seok Won
SW
Kim
Cement; Osteonecrosis; Screw