2023, Vol. 27 ›› Issue (3): 385-390

Biomechanical comparison between a novel bone cement screw system and common surgical methods for the treatment of Kummell’s disease

Zhan Yi1, 2, Wang Biao1, Ma Yuli3, He Simin1, Sun Honghui1, Hao Dingjun1   

Abstract: BACKGROUND: Kyphoplasty and vertebroplasty, as the main treatment of Kummell’s disease, are prone to bone cement displacement during or after surgery. Concerning this complication, the authors’ team designed a novel bone cement screw system.
OBJECTIVE: To explore the application value of the novel bone cement screw system in Kummell’s disease.
METHODS: Thoracolumbar vertebrae specimens of 15 fresh female adult cadavers aged over 60 years were used, and no fractures or deformities were found in the specimens, and all were associated with osteoporosis. The T12-L2 segments were taken, and the Kummell’s disease models were made at the L1 segment, and then five type bone cement repair models were established: group A: vertebroplasty; group B: vertebroplasty combined with unilateral pediculoplasty; group C: vertebroplasty combined with bilateral pediculoplasty model; group D: unilateral novel bone cement screw combined with vertebroplasty model; group E: bilateral novel bone cement screw combined with vertebroplasty model; each group of models contained three specimens. The three-dimensional motions in the six directions of anterior flexion and posterior extension, left and right lateral bending, and left and right rotation were performed by the six-axis spine robot.
RESULTS AND CONCLUSION: (1) The five models were well filled with bone cement, and there was no bone cement leakage or bone cement displacement. (2) Under the anterior flexion, posterior extension, left and right lateral bending, the bone cement stability of the groups D and E was better than that of the other three models (P < 0.05). The novel bone cement screw system in the anterior flexion state had the best biomechanical stability, followed by the extension state. Under the left and right rotation, there were no statistical differences the between the five groups of models (P > 0.05). There was almost no significant difference in bone cement stability in the six directions of motion in groups D and E (P > 0.05). (3) For Kummell’s disease, the novel bone cement screw system has better biomechanical stability than the current commonly used treatments, and both unilateral and bilateral novel bone cement screw systems have good results.
Key words: Kummell’s disease, thoracolumbar spine, screw, internal fixation, biomechanics, injury, repair, intravertebral vacuum cleft