2025, Vol. 29 ›› Issue (34): 7286-7292

Cement-augmented short-segment percutaneous pedicle screw fixation for the stage II Kümmell’s disease

Sheng Wenbo, Liu Bingli, Li Sibo, Ao Rongguang, Yu Baoqing   

Abstract: BACKGROUND: Stage II Kümmell’s disease has traditionally been treated with percutaneous kyphoplasty, but this approach is associated with a high incidence of complications such as poor postoperative pain relief, suboptimal cement dispersion, and adjacent vertebral fractures. Studies have shown that cement augmentation of the injured vertebra combined with posterior spinal canal decompression and short-segment fixation has a good effect on the treatment of Kümmell’s disease with neurological symptoms.
OBJECTIVE: To compare the outcomes of cement-augmented short-segment percutaneous pedicle screw fixation with those of percutaneous kyphoplasty for the treatment of stage II Kümmell’s disease.
METHODS: From January 2020 to January 2023, a total of 49 patients with stage II Kümmell’s disease from Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine were included in this study, with 15 males and 34 females. According to the treatment method, the patients were divided into the trial group (n=23) and the control group (n=26). The patients in the trial group received cement-augmented short-segment percutaneous pedicle screw fixation, and the patients in the control group received percutaneous kyphoplasty. The postoperative complications were recorded, and the spinal Cobb angle and the ratio of the anterior edge height of the injured vertebra were compared between the two groups at 1, 6, 12 weeks, 6, and 12 months after surgery. The Oswestry disability index and lumbar visual analog score were compared at 1 week and 12 months after surgery.
RESULTS AND CONCLUSION: (1) All patients in the two groups were followed up for more than 12 months after surgery. Five patients in the control group had adjacent vertebral fractures, three patients had severe kyphosis, and one patient in the trial group had postoperative incision complications. (2) Compared with preoperative data, the spinal Cobb angle and the ratio of the anterior edge height of the injured vertebra in both groups were significantly improved after surgery (P < 0.05). The spinal Cobb angle of the trial group was lower than that of the control group at 1, 6, 12 weeks, 6, and 12 months after surgery (P < 0.05), and the ratio of the anterior edge height of the injured vertebra in the trial group was higher than that of the control group at 1, 6, 12 weeks, 6, and 12 months after surgery (P < 0.05). (3) Compared with preoperative data, the Oswestry disability index and lumbar visual analog scale score of the two groups were significantly improved after surgery (P < 0.05). The Oswestry disability index and lumbar visual analog scale score of the trial group were lower than those of the control group at 1 week and 12 months after surgery (P < 0.05). (4) The results show that compared with percutaneous kyphoplasty, cement-augmented short-segment percutaneous pedicle screw fixation for stage II Kümmell’s disease can better restore the height of the affected vertebra, maintain the shape of the affected vertebra, improve spinal function, and alleviate lumbar pain.

Key words: Kümmell’s disease, short-segment internal fixation, vertebral body cement augmentation, kyphoplasty, bone cement screw, engineered bone material