A clinical study of improved percutaneous vertebroplasty for treatment of Kummell’s disease without neurological symptoms

[Objective] To investigate the clinical effect of improved percutaneous vertebroplasty (PVP) for the treatment of Kummell’s disease without neurological symptoms. [Methods] Thirty-nine Kummell’s disease patients without neurological symptoms, including 7 males and 32 females aged between 59 and 89, who received surgery on their T8-L5 vertebrae at our hospital from November 2022 to February 2024 were included in this study. Of them, 18 received the improved PVP surgery and 21 underwent the traditional bilateral PVP surgery. Both groups of patients had complete follow-up data for 6-15 months, averaging (9.28±1.99) months. Outcome measures included intraoperative bone cement leakage, bone cement injection volume, C-arm fluoroscopic frequency, operation time, visual analog scale (VAS) and Oswestry disability index (ODI) before operation, 1d after operation, and at the last follow-up. The two surgical operations were approved by the Ethics Committee of Loudi Central Hospital in Hunan Province. [Results] All the 39 patients were successfully operated and had complete follow-up data. ① The bone cement injection volume in the improved PVP group was significantly higher than that in the traditional PVP group (P＜0.01). ② The operation time and intraoperative C-arm fluoroscopic frequency of the improved PVP group were significantly less than those of the traditional PVP group (P＜0.05). ③ Both groups did not suffer nerve injury and other severe complications during operation. Bone cement leakage occurred in 12 patients (66.67%) of the improved PVP group and 16 patients (76.19%) of the traditional PVP group. The difference in bone cement leakage between the two groups was not significant (P＞0.05). ④ The VAS and ODI scores of both groups were significantly improved after surgery (P＜0.05). There was no significant difference in VAS and ODI scores 1d after operation and at the last follow-up between the two groups (P＞0.05). [Conclusion] Both improved and traditional PVP have good effects and high safety in the treatment of Kummell’s disease without neurological symptoms. However, the former has advantages of shorter operation time, a lower C-arm fluoroscopic frequency, and higher bone cement injection volume.