title: Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell's disease: A retrospective study.
abstract: BACKGROUND
  Post traumatic osteonecrosis of a vertebral body occurring in a delayed fashion was first described by the German doctor Kümmell in 1895. Several studies have reported percutaneous vertebroplasty (PVP), or percutaneous kyphoplasty (PKP) for Kümmell's disease achieves good outcomes. However, it is unknown whether a technique is superior for the treatment of this disease. The objective of the study is to compare the efficacy of PVP and PKP for the treatment of Kümmell's disease.
  
  
  METHODS
  A retrospective review was conducted for 73 patients with Kümmell's disease. PVP was performed in 38 patients and PKP in 35 patients. Visual analogue score (VAS) was used to evaluate pain. The anterior vertebral height was measured. The operative time, the incidence of cement leakage and the costs were recorded.
  
  
  RESULTS
  In both PVP group and PKP group, the VAS and anterior vertebral height significantly improved at 1-day postoperatively (P < 0.05), and the improvement sustained at the final followup (P > 0.05). Between the PVP and PKP groups, there were no significant differences in VAS and the anterior vertebral height at 1-day postoperatively and at the final followup (P > 0.05). The operating time and expense in the PKP group were higher than the PVP group (P < 0.001). Cement leakages in the PKP group were fewer than PVP group (P < 0.05).
  
  
  CONCLUSIONS
  PVP is a faster, less expensive option that still provides a comparable pain relief and restoration of vertebral height to PKP for the treatment of Kümmell's disease. PKP has a significant advantage over PVP in term of the fewer cement leakages.
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Guang-Quan
authors.initials: GQ
authors.lastname: Zhang
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Yan-Zheng
authors.initials: YZ
authors.lastname: Gao
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Shu-Lian
authors.initials: SL
authors.lastname: Chen
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Ding
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Orthopedic, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Hong-Qiang
authors.initials: HQ
authors.lastname: Wang
keywords: Intravertebral cleft; Kümmell's disease; Osteonecrosis; aseptic necrosis of bone; avascular necrosis of bone; bone cements; intravertebral vacuum phenomenon; kyphoplasty; vertebrae; vertebroplasty