Short-Segment Bone Cement-Augmented Pedicle Screw Fixation Combined With Bone Grafting for Management of Kummell Disease With Segmental Instability

采用短节段骨水泥增强椎弓根螺钉固定联合植骨术治疗伴节段性不稳定的库梅尔氏病

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Abstract

BACKGROUND Percutaneous kyphoplasty and vertebroplasty are the most commonly used minimally invasive procedures for Kümmell disease. However, they are not always effective in treating Kümmell disease with segmental instability. This study aimed to evaluate the efficacy of short-segment bone cement-augmented pedicle screw fixation combined with bone grafting in the treatment of Kümmell disease with segmental instability. MATERIAL AND METHODS The study included 23 patients treated with short-segment bone cement-augmented pedicle screw fixation combined with bone grafting between January 2021 and January 2024. The Oswestry Disability Index (ODI), visual analog scale (VAS) score, vertebral anterior height, and kyphotic Cobb angle were evaluated. The operation time, hospital stay, intraoperative blood loss, and complications were recorded. RESULTS The VAS scores, ODI scores, vertebral anterior height, and kyphotic Cobb angles showed statistically significant differences between before and 1 week after surgery and between before surgery and at final follow-up (P<0.05). VAS and ODI at the final follow-up were lower than those measured 1 week postoperatively (P<0.05), but no significant difference was found in the vertebral anterior height and kyphotic Cobb angle (P>0.05). Twenty-one patients (91.3%) had achieved solid fusion at final follow-up. No serious complications were observed in any of the cases. CONCLUSIONS Short-segment bone cement-augmented pedicle screw fixation combined with bone grafting is a safe and effective treatment for Kümmell disease with segmental instability. This approach can achieve significant pain relief and functional improvement, provide satisfactory correction of kyphosis and vertebral height restoration, and result in a low complication rate.

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